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Endocrine side effects of cancer immunotherapy.

Endocrine side effects of cancer immunotherapy.
Author Information (click to view)

Cukier P, Santini FC, Scaranti M, Hoff AO,


Cukier P, Santini FC, Scaranti M, Hoff AO, (click to view)

Cukier P, Santini FC, Scaranti M, Hoff AO,

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Endocrine-related cancer 2017 10 1224(12) T331-T347 doi 10.1530/ERC-17-0358

Abstract

Immune checkpoint inhibitors have recently become a cornerstone for the treatment of different advanced cancers. These drugs, represented mainly by monoclonal antibodies anti-cytotoxic T-lymphocyte antigen 4 (CTLA-4), anti-programmed cell death protein-1 (PD-1) and anti-PD-1 ligand molecules (PD-L1 and L2), have the ability to reactivate the immune system against tumor cells, but can also trigger a myriad of autoimmune side effects, termed immune-related adverse events (irAEs). In particular, there are a number of endocrine-related irAEs. Current data from clinical trials show increased incidence of hypophysitis with CTLA4 inhibition and thyroid dysfunction with PD-(L)1 blockade. In addition, a few cases of type 1 diabetes mellitus and primary adrenal insufficiency have been reported. We discuss the incidence, clinical manifestations, diagnosis and management of immune-related endocrinopathies in this highly complex context of oncological patients in need of immunotherapies.

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