Endocrine Abstracts

Background: In the last decade, immunotherapy proved to be the frontline in the fight against cancer in a rocketing area of cancer types. Boosting the body’s inherent immune system, a new set of toxicities raised, labeled as immune-related adverse events (irAEs). Endocrine disorders, particularly thyroid dysfunctions, are by far the most frequent irAEs during immune checkpoint inhibitors (ICIs) therapy. New research data explored their predictive impact in cancer patients’ overall survival. An in-depth endocrinological specific study was performed to evaluate endocrine irAEs caused by ICIs.

Methods: This is a retrospective analysis of endocrine irAEs from a cohort of cancer patients (mainly lung cancer and malignant melanoma) treated with ICIs in the Oncology Institute ‘Prof. Dr. Alexandru Trestioreanu’, Bucharest, Romania, from 1 October 2022 to 31 December 2023. The Institute endocrinologist assessed, followed and subsequently treated all the occurring endocrinopathies during immunotherapy. Endocrine irAEs were evaluated according to current medical practice based on routine clinical, biological and imaging criteria.

Results: Of 22 cancer patients that developed endocrine irAEs, we identified 5 cases of hypophysitis, 18 cases of thyroid disorder, 1 case of primary adrenal insufficiency, with one or more endocrine glands being affected. The anterior pituitary disorder involving several hormonal axes such as, thyroid, adrenal and gonadotropic deficiencies were common, with no proof of growth hormone deficit or hypoprolactinemia.

Conclusions: The expected increasing number of both malignancies and ICIs-treated cancer patients in the future exposes the endocrinologist face to face to a new area of pathology. Diagnosing and managing endocrine irAEs requires a collaborative effort between the oncologist and the endocrinologist to promote a better quality of life and a higher survival rate for cancer patients.