The changing clinical spectrum of endocrine adverse events in cancer immunotherapy

Abstract

Immune checkpoint inhibitors (ICIs) have revolutionized the treatment of several malignancies, improving patient survival and quality of life. Endocrinopathies have emerged as a clinically significant group of immune-related adverse events (IRAEs). Although the mechanism of ICI toxicities has not been clarified, inhibition of immune checkpoints reduces immune tolerance to autoantigens, resulting in the development of autoimmunity disorders. We report current evidence regarding endocrine IRAEs that may have diagnostic and therapeutic implications. Management should be focused on a multidisciplinary approach to reach a prompt diagnosis and an appropriate and safe treatment.

Keywords: adrenal insufficiency; adrenalitis; diabetes insipidus; diabetes mellitus; hyperthyroidism; hypocalcemia; hypoparathyroidism; hypopituitarism; hypothyroidism; thyroiditis.