Endocrine-related adverse conditions in patients receiving immune checkpoint inhibition: an ESE clinical practice guideline
Author
Husebye, Eystein SCastinetti, Frederik
Criseno, Sherwin
Curigliano, Giuseppe
Decallonne, Brigitte
Fleseriu, Maria
Higham, Claire E
Lupi, Isabella
Paschou, Stavroula A
Toth, Miklos
van der Kooij, Monique
Dekkers, Olaf M
Publication date
2022-10-25Subject
Oncology. Pathology.Haematology
Public health. Health statistics. Occupational health. Health education
Metadata
Show full item recordAbstract
Immune checkpoint inhibitors (ICI) have revolutionized cancer treatment but are associated with significant autoimmune endocrinopathies that pose both diagnostic and treatment challenges. The aim of this guideline is to provide clinicians with the best possible evidence-based recommendations for treatment and follow-up of patients with ICI-induced endocrine side-effects based on the Grading of Recommendations Assessment, Development, and Evaluation system. As these drugs have been used for a relatively short time, large systematic investigations are scarce. A systematic approach to diagnosis, treatment, and follow-up is needed, including baseline tests of endocrine function before each treatment cycle. We conclude that there is no clear evidence for the benefit of high-dose glucocorticoids to treat endocrine toxicities with the possible exceptions of severe thyroid eye disease and hypophysitis affecting the visual apparatus. With the exception of thyroiditis, most endocrine dysfunctions appear to be permanent regardless of ICI discontinuation. Thus, the development of endocrinopathies does not dictate a need to stop ICI treatment.Citation
Husebye ES, Castinetti F, Criseno S, Curigliano G, Decallonne B, Fleseriu M, Higham CE, Lupi I, Paschou SA, Toth M, van der Kooij M, Dekkers OM. Endocrine-related adverse conditions in patients receiving immune checkpoint inhibition: an ESE clinical practice guideline. Eur J Endocrinol. 2022 Oct 25;187(6):G1-G21. doi: 10.1530/EJE-22-0689Type
ArticlePMID
36149449Publisher
Oxford University Pressae974a485f413a2113503eed53cd6c53
10.1530/EJE-22-0689