Colombo Carla, De Leo Simone, Campisi Ilaria, Palesandro Erica, Turco Fabio, Buttigliero Consuelo, Fugazzola Laura, Tucci Marcello
Endocrine Oncology Unit, Department of Endocrine and Metabolic Diseases, Istituto Auxologico Italiano IRCCS, Milan, Italy; Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy.
Endocrine Oncology Unit, Department of Endocrine and Metabolic Diseases, Istituto Auxologico Italiano IRCCS, Milan, Italy.
Crit Rev Oncol Hematol. 2025 May;209:104627. doi: 10.1016/j.critrevonc.2025.104627. Epub 2025 Feb 6.
Nowadays immune-based combinations are the standard first-line treatment for metastatic renal cell carcinoma and involve the use of either two immunotherapy agents or an immunotherapeutic drug associated with a tyrosine kinase inhibitor. Treatment-related toxicity is the primary cause of drug discontinuation or dose reduction. A thorough understanding of the prevention and management of adverse events of the immune-based combinations is critical to ensure the success of treatment. Endocrinological toxicities during treatment with immune-based combinations are frequent and often manageable. However, in some cases, diagnosis can be complex, and the treatment requires multidisciplinary discussion. In addition, it is often challenging to determine which agent in the combination is responsible for a specific toxicity. In this review, we analyze the evidence regarding treatment-related endocrinopathies in renal cell carcinoma first-line therapy. We also discuss monitoring strategies to diagnose endocrinological adverse events and provide some practical tools for their daily management.
如今，基于免疫的联合疗法是转移性肾细胞癌的标准一线治疗方法，包括使用两种免疫治疗药物或一种与酪氨酸激酶抑制剂联合使用的免疫治疗药物。治疗相关毒性是药物停用或剂量减少的主要原因。全面了解基于免疫的联合疗法不良事件的预防和管理对于确保治疗成功至关重要。基于免疫的联合疗法治疗期间的内分泌毒性很常见，且通常可控。然而，在某些情况下，诊断可能很复杂，治疗需要多学科讨论。此外，确定联合疗法中的哪种药物导致特定毒性往往具有挑战性。在本综述中，我们分析了肾细胞癌一线治疗中与治疗相关的内分泌病的证据。我们还讨论了诊断内分泌不良事件的监测策略，并提供了一些日常管理的实用工具。
