Endocrine dysfunction induced by immune checkpoint inhibitors: Practical recommendations for diagnosis and clinical management

Cancer. 2018 Mar 15;124(6):1111-1121. doi: 10.1002/cncr.31200. Epub 2018 Jan 3.


Immune checkpoint inhibitors (ICIs) have revolutionized cancer therapy. However, because ICIs block coinhibitory molecules on T cells and other immune cells, unleashing them to mediate tumor cell killing, they also can disrupt the maintenance of immunological tolerance to self-antigens. Compared with chemotherapy, ICIs have a different toxicity profile, especially the occurrence of autoimmune-like manifestations against multiple organ systems, including endocrine glands, commonly referred to as immune-related adverse events. The aim of this review was to provide practical recommendations regarding the proper assessment and clinical management related to the new onset of endocrinopathies after the use of ICIs in patients with cancer. Cancer 2018;124:1111-21. © 2018 American Cancer Society.

Keywords: adrenal insufficiency; autoimmune diabetes; hyperthyroidism; hypophysitis; hypothyroidism; immune checkpoint inhibitors; immune-related adverse events; thyroiditis.

Publication types

  • Review

MeSH terms

  • Antineoplastic Agents, Immunological / administration & dosage
  • Antineoplastic Agents, Immunological / adverse effects*
  • Autoimmunity / drug effects
  • Costimulatory and Inhibitory T-Cell Receptors / antagonists & inhibitors*
  • Costimulatory and Inhibitory T-Cell Receptors / immunology
  • Endocrine Glands / drug effects
  • Endocrine Glands / immunology
  • Endocrine System Diseases / chemically induced
  • Endocrine System Diseases / diagnosis*
  • Endocrine System Diseases / therapy
  • Humans
  • Neoplasms / drug therapy*
  • Neoplasms / immunology
  • Practice Guidelines as Topic


  • Antineoplastic Agents, Immunological
  • Costimulatory and Inhibitory T-Cell Receptors