Endocrine Side Effects in Patients Treated with Immune Checkpoint Inhibitors: A Narrative Review

Checkpoint inhibitors are monoclonal antibodies that elicit an anti-tumor response by stimulating immune system. Their use has improved the treatment of different types of cancer such as melanoma, breast carcinoma, lung, stomach, colon, liver, renal cell carcinoma, and Hodgkin's lymphoma, but several adverse events have been reported. Although the etiology of these effects is not completely understood, an uncontrolled activation of the immune system has been postulated. Indeed, some studies showed a cross reactivity of T cells, which acted against tumor antigens as well as antigens in the tissues of patients who developed immune-related adverse events. Despite the known possibility of developing immune-related adverse events, early diagnosis, monitoring during therapy, and treatment are fundamental for the best supportive care and administration of immune checkpoint inhibitors. The aim of this review is to guide the clinician in early diagnosis, management, and treatment of the endocrinological adverse effects in the major endocrine glands (thyroid, pituitary, adrenal, endocrine pancreas, and parathyroid).

Automated summary

Checkpoint inhibitors enhance the immune system to fight against tumors and have improved the treatment of various cancers, but they can also cause adverse events. The underlying mechanism is not completely understood, but it is believed to be due to uncontrolled activation of the immune system. T cells have been found to react against both tumor antigens and antigens in the tissues of patients who developed immune-related adverse events. Early diagnosis, monitoring, and treatment are crucial for managing these adverse effects and ensuring the best supportive care and administration of checkpoint inhibitors.