| Abstract [eng] |
In recent years, immunotherapy has become a revolutionary treatment option for many types of cancer. Over-activated immune cells can cause autoimmune damage to a wide range of organs, including the skin, the gastrointestinal tract, the lungs, the heart, the kidneys, and the endocrine system. Approximately 10% of all cancer patients treated with Immune Checkpoint Inhibitors (ICIs) experience endocrine adverse reactions. Thyroid dysfunction is the most common endocrinopathy caused by ICIs, which can present as thyrotoxicosis or hypothyroidism, and is mostly associated with therapy using Programmed Cell Death Protein 1 (PD-1) and its ligand (PD-L1) inhibitors, or with combination immunotherapy. Although most endocrinopathies provoked by ICIs treatment present with relatively mild symptoms, rare cases of thyrotoxic crisis, myxedema coma, or adrenal crisis are also reported. Hypophysitis is most common in patients receiving combination therapy and is also associated with treatment with Cytotoxic T-Lymphocyte-Associated Protein 4 (CTLA-4) inhibitors, particularly ipilimumab. This paper aims to review the recent scientific literature. The main objectives are to describe the prevalence, pathogenesis, clinical presentation, state-of-the-art diagnostic modalities, and treatment options for endocrinopathies in oncological patients undergoing immunotherapy. To conduct the literature review, "PubMed (MEDLINE)" and "Google Scholar" medical databases were searched using specific keywords and selection criteria. After reviewing the titles and abstracts of the articles, a total of 52 articles were selected for the literature review. The topic is of real relevance as immunotherapy is a modern and increasingly used treatment modality, which in some patients also causes adverse effects. Knowing why they occur, recognizing them in time, and treating them appropriately is therefore important for the well-being of patients and better treatment effectiveness. |
