TY - JOUR
T1 - Endocrine-related adverse conditions in patients receiving immune checkpoint inhibition
T2 - an ESE clinical practice guideline
AU - Husebye, Eystein S.
AU - Castinetti, Frederik
AU - Criseno, Sherwin
AU - Curigliano, Giuseppe
AU - Decallonne, Brigitte
AU - Fleseriu, Maria
AU - Higham, Claire E.
AU - Lupi, Isabella
AU - Paschou, Stavroula A.
AU - Toth, Miklos
AU - van der Kooij, Monique
AU - Dekkers, Olaf M.
N1 - Publisher Copyright:
© 2022 The authors Published by Bioscientifica Ltd.
PY - 2022/12
Y1 - 2022/12
N2 - 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.
AB - 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.
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U2 - 10.1530/EJE-22-0689
DO - 10.1530/EJE-22-0689
M3 - Article
C2 - 36149449
AN - SCOPUS:85140855162
SN - 0804-4643
VL - 187
SP - G1-G21
JO - European journal of endocrinology
JF - European journal of endocrinology
IS - 6
ER -