El Sabbagh Rawaa, Azar Nadim S, Eid Assaad A, Azar Sami T
Division of Endocrinology and Metabolism, American University of Beirut, Beirut, Lebanon.
Department of Internal Medicine, American University of Beirut, Beirut, Lebanon.
Int J Gen Med. 2020 Nov 4;13:1003-1009. doi: 10.2147/IJGM.S261433. eCollection 2020.
Immune checkpoint inhibitors are anti-cancer drugs associated with adverse events that result from releasing the immune system against self-antigens while attacking cancer cells. Thyroid dysfunctions are among the most common associated adverse events.
We conducted a systematic search of the literature in 2 databases: PubMed and Medline. Articles that reported thyroid adverse events of immune checkpoint inhibitors were reviewed. Thyroid disorders include hyperthyroidism and hypothyroidism and are most commonly seen with programmed cell death protein 1 and programmed death-ligand 1 inhibitors.
Thyroid disorders are common side effects seen with check point inhibitors and are treated, depending on the clinical situation, by adequate hormonal replacement, thionamides, corticosteroids or observation only. The use of high dose corticosteroids has not been established as a treatment of thyroid toxicities. Thyroid function tests screening should be a part of baseline laboratory testing of all patients undergoing treatment with immune checkpoint inhibitors.
免疫检查点抑制剂是一类抗癌药物，在攻击癌细胞时会引发免疫系统针对自身抗原的反应，从而导致不良事件。甲状腺功能障碍是最常见的相关不良事件之一。
我们在两个数据库（PubMed和Medline）中对文献进行了系统检索。对报道免疫检查点抑制剂甲状腺不良事件的文章进行了综述。甲状腺疾病包括甲状腺功能亢进和甲状腺功能减退，最常与程序性细胞死亡蛋白1和程序性死亡配体1抑制剂相关。
甲状腺疾病是检查点抑制剂常见的副作用，根据临床情况，可通过适当的激素替代、硫代酰胺、皮质类固醇或仅观察来治疗。高剂量皮质类固醇尚未被确立为甲状腺毒性的治疗方法。甲状腺功能测试筛查应成为所有接受免疫检查点抑制剂治疗患者基线实验室检测的一部分。
