Unal M C, Semiz G Güngör, Ozdoğan O, Altay C, Yildirim E Caliskan, Semiz H S, Comlekci A, Akinci B
Endocrinology and Metabolism, Dokuz Eylul University, Faculty of Medicine, Izmir, Turkey.
Nuclear Medicine, Dokuz Eylul University, Faculty of Medicine, Izmir, Turkey.
Acta Endocrinol (Buchar). 2022 Oct-Dec;18(4):516-522. doi: 10.4183/aeb.2022.516.
Immune checkpoint inhibitors (ICIs) have revolutionized the treatment of advanced cancers. Antibodies directed against programmed cell death receptor 1 (PD-1) interrupt the ability of the cancerous cell to depress the immune system.
We report three patients who developed different endocrine abnormalities after treatment with nivolumab, a monoclonal antibody directed against PD-1. First, we report a 76-year-old male presenting with generalized fat loss after treatment with nivolumab which predominantly affected his face and trunk. Second, we described the development of thyroiditis that presented with thyrotoxicosis and the expression of thyroid-stimulating hormone receptor antibodies (TRAb). Finally, we observed the emergence of adrenal insufficiency due to hypophysitis in another case.
Although immune checkpoint inhibitors are an effective anticancer treatment modality, adverse effects are evident that can affect the endocrine system. These adverse events may relate to different endocrine systems that include the thyroid and pituitary glands. Also, acquired generalized lipodystrophy should be suspected in patients developing unusual fat loss after treatment with ICIs.
免疫检查点抑制剂（ICIs）彻底改变了晚期癌症的治疗方式。针对程序性细胞死亡受体1（PD-1）的抗体可阻断癌细胞抑制免疫系统的能力。
我们报告了3例接受抗PD-1单克隆抗体纳武单抗治疗后出现不同内分泌异常的患者。首先，我们报告了1例76岁男性，在接受纳武单抗治疗后出现全身脂肪减少，主要影响面部和躯干。其次，我们描述了表现为甲状腺毒症和促甲状腺激素受体抗体（TRAb）表达的甲状腺炎的发生。最后，在另一例患者中，我们观察到因垂体炎导致的肾上腺功能不全。
尽管免疫检查点抑制剂是一种有效的抗癌治疗方式，但明显存在可影响内分泌系统的不良反应。这些不良事件可能与包括甲状腺和垂体在内的不同内分泌系统有关。此外，接受ICIs治疗后出现异常脂肪减少的患者应怀疑获得性全身性脂肪营养不良。
