Immune checkpoint therapy had gained popularity in recent decades and was increasingly being used to treat advanced malignancies. Although data on the toxicities of these medications were being collected, nothing was known about their toxicity profile in terms of sexual function. For a review, researchers determined the endocrine/sexual side effects of anti-PD-1/PD-L1 and anti-CTLA-4 treatment. The programmed death (PD) pathway was the primary focus of the evaluation, which comprised 32 studies. Researchers discovered that endocrine adverse effects following anti-PD-1/PD-L1 medication were uncommon, with hypothyroidism (range < 1 to 40%) and hypophysitis (range < 1 to 10%) being the two most prevalent. There was no mention of infertility or sexual negative effects in any of the investigations. However, two studies that looked at the biochemical profiles of individuals receiving ipilimumab (a CTLA-4 inhibitor) or combination treatment (CTLA-4 + PD-1/PD-L1 inhibitors) found that less than 1 to ~ 60% of the patients had hypogonadotropic hypogonadism. None of the studies reported on clinically relevant sexual health outcomes such as libido, erectile function evaluations, or sexual function-related quality of life.
Although endocrine adverse effects were infrequent, they were significant and distinct side effects of immune checkpoint treatment since they were frequently complicated and can be fatal. While the side effects on sexual health were not life-threatening, they limited one’s lifestyle. Long-term follow-up, post-marketing surveillance, and future research were required to determine the real incidence of endocrine/sexual side effects and the mechanisms behind them. As more patients experience the innovative immune checkpoint inhibitor medicines, it is likely to assist in better patient counseling.
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