Autoimmune Endocrinopathies: An Emerging Complication of Immune Checkpoint Inhibitors

Annu Rev Med. 2021 Jan 27:72:313-330. doi: 10.1146/annurev-med-050219-034237. Epub 2020 Sep 4.

Abstract

Immune checkpoint inhibitors (CPIs) reverse immune suppression that is thought to allow malignant growth. Despite remarkable efficacy in a subset of cancers, their use is accompanied by immune-related adverse events, including endocrinopathies such as hypophysitis, thyroid dysfunction, diabetes, and adrenalitis. These conditions are heterogenous, with differing incidence across CPI types, but are unified by the acuity and extremity of tissue-specific organ failure. Their occurrence may be associated with beneficial tumor control. Further understanding of the risk factors and mechanisms of these endocrine immunotoxicities can help optimize CPI use as well as improve understanding of spontaneous autoimmune diseases.

Keywords: diabetes; endocrine disease; hypophysitis; immune checkpoint inhibitors; immune-related adverse events; thyroid dysfunction.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Autoimmune Diseases / chemically induced*
  • Autoimmune Diseases / immunology
  • Autoimmunity / drug effects*
  • Endocrine System Diseases / chemically induced*
  • Endocrine System Diseases / immunology
  • Humans
  • Immune Checkpoint Inhibitors / adverse effects*

Substances

  • Immune Checkpoint Inhibitors