Diagnostic criteria and proposed management of immune-related endocrinopathies following immune checkpoint inhibitor therapy for cancer
Checkpoint inhibitors are now widely used in the management of many cancers. Endocrine toxicity is amongst the most common side effects. These endocrinopathies differ from most other immune-related toxicities in frequently being irreversible and rarely requiring cessation of checkpoint inhibitor the...
| Main Authors: | , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Bioscientifica
2023-04-01
|
| Series: | Endocrine Connections |
| Subjects: | |
| Online Access: | https://ec.bioscientifica.com/view/journals/ec/12/5/EC-22-0513.xml |
| _version_ | 1797843500342968320 |
|---|---|
| author | Ruth Percik Sherwin Criseno Safwaan Adam Kate Young Daniel L Morganstein |
| author_facet | Ruth Percik Sherwin Criseno Safwaan Adam Kate Young Daniel L Morganstein |
| author_sort | Ruth Percik |
| collection | DOAJ |
| description | Checkpoint inhibitors are now widely used in the management of many cancers. Endocrine toxicity is amongst the most common side effects. These endocrinopathies differ from most other immune-related toxicities in frequently being irreversible and rarely requiring cessation of checkpoint inhibitor therapy. This review considers an approach to the presentation and diagnosis of endocrinopathies, compared to classical endocrine diagnosis, suggesting improvements to classification and treatment based on fundamental endocrine principles. These will help to align management with other similar endocrine conditions and standardise the diagnosis and reporting of endocrine toxicity of checkpoint inhibitors to improve both endocrine and oncological care. In particular, the importance of considering any inflammatory phase (such as painful thyroiditis or hypophysitis resulting in the pituitary enlargement), from the endocrine consequences (transient hyperthyroidism followed by hypothyroidism, pan-hypopituitarism or isolated adrenocorticotrophic hormone deficiency), is highlighted. It is also important to consider the potential confounder of exogenous corticosteroids in adrenal suppression. |
| first_indexed | 2024-04-09T17:07:05Z |
| format | Article |
| id | doaj.art-4cd5b8b278ce47c8b11dc5765e692690 |
| institution | Directory Open Access Journal |
| issn | 2049-3614 |
| language | English |
| last_indexed | 2024-04-09T17:07:05Z |
| publishDate | 2023-04-01 |
| publisher | Bioscientifica |
| record_format | Article |
| series | Endocrine Connections |
| spelling | doaj.art-4cd5b8b278ce47c8b11dc5765e6926902023-04-20T12:23:11ZengBioscientificaEndocrine Connections2049-36142023-04-01125113https://doi.org/10.1530/EC-22-0513Diagnostic criteria and proposed management of immune-related endocrinopathies following immune checkpoint inhibitor therapy for cancerRuth Percik0Sherwin Criseno1Safwaan Adam2Kate Young3Daniel L Morganstein4Institute of Endocrinology, Diabetes and Metabolism, Sheba Medical Centre, Ramat Gan, IsraelDepartment of Endocrinology, University Hospital Birmingham, Birmingham, UKDepartment of Endocrinology, The Christie NHS Foundation Trust, Manchester, UKRoyal Marsden Hospital, London, UKDepartment of Endocrinology, Chelsea and Westminster Hospital, London, UK; Royal Marsden Hospital, London, UK Checkpoint inhibitors are now widely used in the management of many cancers. Endocrine toxicity is amongst the most common side effects. These endocrinopathies differ from most other immune-related toxicities in frequently being irreversible and rarely requiring cessation of checkpoint inhibitor therapy. This review considers an approach to the presentation and diagnosis of endocrinopathies, compared to classical endocrine diagnosis, suggesting improvements to classification and treatment based on fundamental endocrine principles. These will help to align management with other similar endocrine conditions and standardise the diagnosis and reporting of endocrine toxicity of checkpoint inhibitors to improve both endocrine and oncological care. In particular, the importance of considering any inflammatory phase (such as painful thyroiditis or hypophysitis resulting in the pituitary enlargement), from the endocrine consequences (transient hyperthyroidism followed by hypothyroidism, pan-hypopituitarism or isolated adrenocorticotrophic hormone deficiency), is highlighted. It is also important to consider the potential confounder of exogenous corticosteroids in adrenal suppression.https://ec.bioscientifica.com/view/journals/ec/12/5/EC-22-0513.xmlcancercheckpoint inhibitorimmunotherapyendocrinopathyhypopituitarismthyroid |
| spellingShingle | Ruth Percik Sherwin Criseno Safwaan Adam Kate Young Daniel L Morganstein Diagnostic criteria and proposed management of immune-related endocrinopathies following immune checkpoint inhibitor therapy for cancer Endocrine Connections cancer checkpoint inhibitor immunotherapy endocrinopathy hypopituitarism thyroid |
| title | Diagnostic criteria and proposed management of immune-related endocrinopathies following immune checkpoint inhibitor therapy for cancer |
| title_full | Diagnostic criteria and proposed management of immune-related endocrinopathies following immune checkpoint inhibitor therapy for cancer |
| title_fullStr | Diagnostic criteria and proposed management of immune-related endocrinopathies following immune checkpoint inhibitor therapy for cancer |
| title_full_unstemmed | Diagnostic criteria and proposed management of immune-related endocrinopathies following immune checkpoint inhibitor therapy for cancer |
| title_short | Diagnostic criteria and proposed management of immune-related endocrinopathies following immune checkpoint inhibitor therapy for cancer |
| title_sort | diagnostic criteria and proposed management of immune related endocrinopathies following immune checkpoint inhibitor therapy for cancer |
| topic | cancer checkpoint inhibitor immunotherapy endocrinopathy hypopituitarism thyroid |
| url | https://ec.bioscientifica.com/view/journals/ec/12/5/EC-22-0513.xml |
| work_keys_str_mv | AT ruthpercik diagnosticcriteriaandproposedmanagementofimmunerelatedendocrinopathiesfollowingimmunecheckpointinhibitortherapyforcancer AT sherwincriseno diagnosticcriteriaandproposedmanagementofimmunerelatedendocrinopathiesfollowingimmunecheckpointinhibitortherapyforcancer AT safwaanadam diagnosticcriteriaandproposedmanagementofimmunerelatedendocrinopathiesfollowingimmunecheckpointinhibitortherapyforcancer AT kateyoung diagnosticcriteriaandproposedmanagementofimmunerelatedendocrinopathiesfollowingimmunecheckpointinhibitortherapyforcancer AT daniellmorganstein diagnosticcriteriaandproposedmanagementofimmunerelatedendocrinopathiesfollowingimmunecheckpointinhibitortherapyforcancer |