Iwama Shintaro
Dept. of Endocrinology and Diabetes, Nagoya University Hospital.
Gan To Kagaku Ryoho. 2020 Feb;47(2):203-206.
Immune checkpoint inhibitors(ICIs)have been widely used in patients with advanced malignancies. However, these drugs can cause immune-related adverse events(irAEs)in several organs, including lung, skin, gastrointestinal tract, liver, nerve, muscle, and endocrine organs. Endocrine irAEs include hypopituitarism, primary adrenal insufficiency, thyroid dysfunction, hypoparathyroidism, and type 1 diabetes mellitus, which can result in life-threatening consequences, such as adrenal crisis, thyroid storm, severe hypocalcemia, and diabetic ketoacidosis. Therefore, it is important to understand the clinical features of each endocrine irAE and to manage them appropriately. Recently, we have reported that the presence ofanti -thyroid antibodies at baseline become a biomarker to find the high-risk patients for thyroid dysfunction induced by anti-PD-1 antibody, nivolumab.
免疫检查点抑制剂（ICIs）已广泛应用于晚期恶性肿瘤患者。然而，这些药物可在包括肺、皮肤、胃肠道、肝脏、神经、肌肉和内分泌器官在内的多个器官引起免疫相关不良事件（irAEs）。内分泌irAEs包括垂体功能减退、原发性肾上腺功能不全、甲状腺功能障碍、甲状旁腺功能减退和1型糖尿病，这些可导致危及生命的后果，如肾上腺危象、甲状腺风暴、严重低钙血症和糖尿病酮症酸中毒。因此，了解每种内分泌irAE的临床特征并进行适当管理很重要。最近，我们报道基线时抗甲状腺抗体的存在成为发现抗PD-1抗体纳武单抗诱导的甲状腺功能障碍高危患者的生物标志物。
