Thyroid disorders induced by immune checkpoint inhibitors therapy of malignant tumors

Abstract

In the recent years, immune checkpoint inhibitors (ICPI) have been widely used for treatment of many malignant neoplasms. In the Russian Federation, several ICPIs have been approved and actively used, namely anti-CTLA-4 monoclonal antibody (ipilimumab), anti-PD-1 monoclonal antibodies (nivolumab, pembrolizumab, prolgolimab), and anti-PD-L1 monoclonal antibodies (atezolizumab, durvalumab). ICPIs may cause various endocrine immune-mediated adverse events, most commonly thyroid dysfunction and hypophysitis, which are at large associated with anti-tumor therapy with a certain subgroup of these agents. Predictors of endocrine immune-mediated adverse events remain unclear, and their optimal prevention, prediction and treatment have not been yet defined. The review contains the information accumulated in the literature on the mechanisms, biomarkers, specific characteristics of thyroid immune-mediated adverse events and describes the principles of treatment for these thyroid disorders. This information would be useful for practicing oncologists, endocrinologists, internists, family physicians, as well as for any other medical specialties.

Keywords

• hypothyroidism
• thyrotoxicosis
• immune checkpoint inhibitors
• ipilimumab
• pembrolizumab
• nivolumab
• prolgolimab
• atezolizumab
• durvalumab
• avelumab