Searchable abstracts of presentations at key conferences in endocrinology
Endocrine Abstracts (2018) 56 S28.3 | DOI: 10.1530/endoabs.56.S28.3

ECE2018 Symposia Endocrinology Meets Immunology (3 abstracts)

Immunotherapy Related Endocrinopathies

Mark Vanderpump


UK.


Recent advances in immunology have resulted in the development of new classes of immune-modulatory therapy in the management of cancers and an increased overall survival for various cancers. Immune checkpoint direct antibodies block intrinsic down-regulators of immunity, such as cytotoxic T-lymphocyte antigen 4 (CTLA-4) and programmed cell death 1 (PD-1) or its ligand, programmed cell death ligand 1 (PD-L1). As an inevitable consequence of increasing the activity of the immune system, immune checkpoint blockade result in immune-related adverse events (IRAEs). Although any organ can be affected, IRAEs commonly involve endocrine glands. Endocrinopathies described include hypophysitis with or without hypopituitarism, thyroid dysfunction (transient thyrotoxicosis, transient or permanent hypothyroidism, orbitopathy) and rarely adrenalitis and autoimmune insulin-requiring diabetes. The management of hypophysitis, a potentially life-threatening complication, primarily involves replacement of deficient pituitary hormones and consideration of drug discontinuation and/or immunosuppressive glucocorticoid therapy. Hyperthyroidism, most commonly due to a transient thyroiditis than Graves’ disease, should be managed conventionally. Primary hypothyroidism, hypoadrenalism and autoimmune diabetes should also be treated with conventional replacement. IRAEs usually develop within the first few weeks to months after treatment initiation but can present after cessation of therapy. Some studies suggest that patients with IRAEs have higher tumour response rates than those without such events, but these findings remain controversial and the development of IRAEs is not required for treatment benefit. There are no clinical or biochemical features which predict those patients who will develop IRAEs. In the absence of clinical trials, management strategies for effectively monitoring or managing specific IRAEs remains variable and are currently based on consensus opinion.

Volume 56

20th European Congress of Endocrinology

Barcelona, Spain
19 May 2018 - 22 May 2018

European Society of Endocrinology 

Browse other volumes

Article tools

My recent searches

No recent searches.

My recently viewed abstracts