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The influence of monoclonal antibodies for cancer treatment on the endocrine system

Kamil Dyrka
Kamil Dyrka
, 
Daria Witasik
Daria Witasik
, 
Agata Czarnywojtek
Agata Czarnywojtek
 e 
Katarzyna Łącka
Katarzyna Łącka
   | 18 mag 2021
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Article Category: Review
Pubblicato online: 18 mag 2021
Pagine: 317 - 327
Ricevuto: 15 nov 2020
Accettato: 26 feb 2021
DOI: https://doi.org/10.5604/01.3001.0014.8889
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© 2021 Kamil Dyrka et al., published by Sciendo
This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

Fig. 1

Endocrine parameters that should be monitored in patients during monoclonal antibody treatment. A – endocrine side effects management algorithm [77], B – proposition of endocrine inspection during ICPi treatment [36]*TSH and FT4 measurement could be done each week during the first 2 months of ICPi treatment**If there is no corticosteroid treatmentAbbreviations: ICPi: Immune checkpoint inhibitor, TSH: Thyroid-stimulating hormone, FT4: Free thyroxine, ACTH: Adrenocorticotropic hormone, HbA1c: Hemoglobin A1c, LLN: below limit of normal, ULN: upper limit of normal, IV: intravenous, PO: per os.
Endocrine parameters that should be monitored in patients during monoclonal antibody treatment. A – endocrine side effects management algorithm [77], B – proposition of endocrine inspection during ICPi treatment [36]*TSH and FT4 measurement could be done each week during the first 2 months of ICPi treatment**If there is no corticosteroid treatmentAbbreviations: ICPi: Immune checkpoint inhibitor, TSH: Thyroid-stimulating hormone, FT4: Free thyroxine, ACTH: Adrenocorticotropic hormone, HbA1c: Hemoglobin A1c, LLN: below limit of normal, ULN: upper limit of normal, IV: intravenous, PO: per os.

Adverse reactions caused by monoclonal antibodies in the endocrine system

Monoclonal antibody Therapeutic indications Very common and common adverse reactions (≥ 1/100) Uncommon adverse reactions (≥ 1/1,000 to < 1/100) Rare and very rare adverse reactions (< 1/1000) References
Atezolizumab

Locally advanced or metastatic UC as monotherapy

Locally advanced or metastatic NSCLC after prior chemotherapy

Unresectable locally advanced or metastatic TNBC (in combination with nab-paclitaxel)

 		hypothyroidism (very common in combination therapy, common as monotherapy) hyperthyroidism, diabetes mellitus, adrenal insufficiency hypophysitis [71]
Avelumab

Metastatic MCC

RCC (in combination with axitinib)

 		hypothyroidism adrenal insufficiency, hyperthyroidism, thyroiditis, autoimmune thyroiditis, adrenocortical insufficiency acute, autoimmune hypothyroidism, hypopituitarism, type 1 diabetes mellitus - [4]
Durvalumab

Locally advanced, unresectable NSCLC

 		hypothyroidism, hyperthyroidism adrenal insufficiency, type 1 diabetes mellitus hypophysitis / hypopituitarism, diabetes insipidus [37]
Ipilimumab

Advanced melanoma (as monotherapy/in combination with ipilimumab)

Adjuvant treatment of melanoma

NSCLC as monotherapy

RCC

relapsed or refractory cHL after autologous stem cell transplant (ASCT) and treatment with brentuximab vedotin

SCCHN

Urothelial Carcinoma

 		hypothyroidism, hyperthyroidism adrenal insufficiency, hypopituitarism, hypophysitis, thyroiditis, diabetes mellitus diabetic ketoacidosis [57]
Pemprolizumab Monotherapy

Advanced melanoma

Adjuvant treatment of adults with Stage III melanoma

NSCLC

cHL

Urothelial carcinoma

SCCHN

 		hypothyroidism, hyperthyroidism adrenal insufficiency, hypophysitis, thyroiditis - [45]
Pemprolizumab Combination with chemotherapy

NSCLC

 		hypothyroidism, hyperthyroidism hypophysitis, thyroiditis, adrenal insufficiency - [45]
Pemprolizumab Combination with axitinib

Advanced RCC

 		hypothyroidism, hyperthyroidism, hypophysitis, thyroiditis, adrenal insufficiency - - [45]
eISSN:
1732-2693
Lingua:
Inglese
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Argomenti della rivista:
Life Sciences, Molecular Biology, Microbiology and Virology, Medicine, Basic Medical Science, Immunology
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