Hattersley Rosie, Nana Melanie, Lansdown Andrew J
Velindre Cancer Centre, Cardiff, UK.
University Hospital of Wales, Cardiff, UK.
Clin Med (Lond). 2021 Mar;21(2):e212-e222. doi: 10.7861/clinmed.2020-0827.
Use of immune checkpoint inhibitors in cancer treatment has increased vastly over the past decade, as both single and combination agent therapies. While having a positive impact on survival rates, adverse effects have been noted, with endocrine effects in around 10% of patients. Thyroid disease and hypophysitis are the most commonly encountered, with diabetes mellitus and primary adrenal insufficiency also reported, as well as more rare endocrinopathies. Patient and clinician education to raise awareness of these effects, as well as regular monitoring to enable early recognition, diagnosis and prompt treatment of the immune side effects, are key. In this review, we discuss the aetiology, presentation and management of the endocrine complications of immunotherapies that are relevant to the general physician, as well as highlighting important areas where further research is still needed.
在过去十年中，免疫检查点抑制剂作为单一药物疗法和联合药物疗法，在癌症治疗中的应用大幅增加。虽然对生存率有积极影响，但也已注意到有不良反应，约10%的患者出现内分泌效应。甲状腺疾病和垂体炎最为常见，也有糖尿病和原发性肾上腺功能不全的报告，以及更罕见的内分泌病。对患者和临床医生进行教育以提高对这些效应的认识，以及定期监测以便早期识别、诊断和及时治疗免疫副作用，是关键。在本综述中，我们讨论了与普通内科医生相关的免疫疗法内分泌并发症的病因、表现和管理，并强调了仍需进一步研究的重要领域。
