New insight in endocrine-related adverse events associated to immune checkpoint blockade

Publication date: Available online 11 December 2019Source: Best Practice & Research Clinical Endocrinology & MetabolismAuthor(s): Giusy Elia, Silvia Martina Ferrari, Maria Rosaria Galdiero, Francesca Ragusa, Sabrina Rosaria Paparo, Ilaria Ruffilli, Gilda Varricchi, Poupak Fallahi, Alessandro AntonelliAbstractAnticancer immunotherapy, in the form of immune checkpoint inhibition (ICI), is a paradigm shift that has transformed the care of patients with different types of solid and hematologic cancers. The most notable improvements have been seen in patients with melanoma, non-small-cell lung, bladder, renal, cervical, urotherial, and colorectal cancers, Merkel cell carcinoma, and Hodgkin lymphoma. Monoclonal antibodies (mAbs) targeting immune checkpoints (i.e., anti-CTLA: ipilimumab; anti-PD-1: nivolumab, pembrolizumab; anti-PD-L1: durvalumab, atezolizumab, avelumab) unleash the immune system against tumor cells targeting mainly T cells. Treatment with ICIs is associated with a variety of diverse and distinct immune-related adverse events (irAEs), reflecting the mechanistic underpinning of each target (i.e., CTLA-4, and PD-1/PD-L1 network). The most frequent endocrine irAEs associated with anti-PD-1 mAb treatment are thyroid dysfunctions, whereas hypophysitis is mostly linked to anti-CTLA-4 treatment. Type 1 diabetes mellitus and adrenalitis are rare irAEs. Combination therapy (anti-CTLA-4 plus anti-PD-1/PD-L1) can be associated with an increased risk and prevalence of endocrine...
Source: Best Practice and Research Clinical Endocrinology and Metabolism - Category: Endocrinology Source Type: research