Adrenal insufficiency induced by immune checkpoint inhibitors anticancer therapy

Immune checkpoint inhibitors (ICIs) have revolutionized cancer treatment and significantly improved the prognosisof patients with advanced tumors. The ICIs are monoclonal antibodies that inhibit regulatory proteins, namely cytotoxicT-lymphocyte-associated antigen 4 (CTLA-4), programmed cell death 1...

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Main Authors: Paulina Ramaneckaite, Zuzanna Ratuszna, Julia Brymora, Ewa Zalewska, Renata Stodulska-Świątkowska
Format: Article
Language:English
Published: Via Medica 2025-01-01
Series:Nowotwory
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Online Access:https://journals.viamedica.pl/nowotwory_journal_of_oncology/article/view/104812
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Summary:Immune checkpoint inhibitors (ICIs) have revolutionized cancer treatment and significantly improved the prognosisof patients with advanced tumors. The ICIs are monoclonal antibodies that inhibit regulatory proteins, namely cytotoxicT-lymphocyte-associated antigen 4 (CTLA-4), programmed cell death 1 (PD-1), and its ligand (PD-L1). The blockageof the key regulatory signaling pathways allows cytotoxic T lymphocytes to reestablish an effective anticancer response.Despite significant clinical benefits, ICIs may electively provoke toxicity of the endocrine system, including adrenalinsufficiency. Recognizing drug-induced adrenal cortex insufficiency may be challenging due to miser manifestationsand non-specific clinical signs. Therefore, diagnosing adrenal dysfunction requires careful monitoring of cortisol and adrenocorticotropichormone levels during ICIs therapy. This review presents up-to-date research on ICIs-induced adrenalinsufficiency. Studies have shown that early detection of deviations from the norm increases the chances of survivalof ICI-triggered autoimmune adrenalitis, the rare but potentially life-threatening complication of anticancer therapies.
ISSN:0029-540X
2300-2115