Immune Checkpoint Inhibitors and endocrine side effects, a narrative review.

Immune Checkpoint Inhibitors and endocrine side effects, a narrative review. Postgrad Med. 2019 Dec 26;: Authors: Agrawal L, Bacal A, Jain S, Singh V, Emanuele N, Emanuele MA, Meah F Abstract Immune checkpoint inhibitors (ICPIs) are novel drugs in the field of oncology however carry the risk of immune related dermatologic, gastrointestinal, and endocrine side effects which can be fatal. These new innovative immunoregulatory drugs have intertwined the fields of oncology and endocrinology. CTLA-4 and PD-1 are co-inhibitory receptors on T cells that turn the T cell "off" when binding to receptors on APCs. Tumor cells can also carry receptors for CTLA- and PD-1. By rendering T cells inactive, tumor cells can evade immune attack. Antibodies that bind to CTLA-4 and PD-1 lead to T cell activation and destruction of both tumor and normal host cells. Immune checkpoint inhibitors have been used in a variety of malignancies including melanoma, kidney cancer, and non-small cell lung cancer. A unique underrecognized side effect of the autoimmune response is hypophysitis leading to central adrenal insufficiency which can be fatal. Additional immune-related adverse events (irAEs) include hypothyroidism, hyperthyroidism, diabetes, and hypoparathyroidism. PMID: 31876444 [PubMed - as supplied by publisher]
Source: Postgraduate Medicine - Category: Internal Medicine Tags: Postgrad Med Source Type: research