Thyroid-related adverse events induced by immune checkpoint inhibitors

Front Endocrinol (Lausanne). 2022 Sep 20:13:1010279. doi: 10.3389/fendo.2022.1010279. eCollection 2022.


Immune checkpoint inhibitors, namely anti-CTLA-4, anti-PD-1 and anti-PD-L1 monoclonal antibodies, have emerged in the last decade as a novel form of cancer treatment, promoting increased survival in patients. As they tamper with the immune response in order to destroy malignant cells, a new type of adverse reactions has emerged, known as immune-related adverse events (irAEs), which frequently target the endocrine system, especially the thyroid and hypophysis. Thyroid irAEs include hyperthyroidism, thyrotoxicosis, hypothyroidism and a possibly life-threatening condition known as the "thyroid storm". Early prediction of occurrence and detection of the thyroid irAEs should be a priority for the clinician, in order to avoid critical situations. Moreover, they are recently considered both a prognostic marker and a means of overseeing treatment response, since they indicate an efficient activation of the immune system. Therefore, a multidisciplinary approach including both oncologists and endocrinologists is recommended when immune checkpoint inhibitors are used in the clinic.

Keywords: CTLA-4; PD-1; PD-L1; cancer treatment; endocrine; immune checkpoint inhibitors; immune-related adverse events; thyroid.

Publication types

  • Review
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Antibodies, Monoclonal / adverse effects
  • Antineoplastic Agents, Immunological* / adverse effects
  • Humans
  • Immune Checkpoint Inhibitors / adverse effects
  • Neoplasms*
  • Thyroid Gland


  • Antibodies, Monoclonal
  • Antineoplastic Agents, Immunological
  • Immune Checkpoint Inhibitors