Primary adrenal insufficiency induced by immune checkpoint inhibitors: biological, clinical, and radiological aspects

被引：7

作者：

Martella, Serafina ^{[1
]}

Lucas, Minke ^{[2
]}

Porcu, Michele ^{[3
]}

Perra, Laura ^{[4
]}

Denaro, Nerina ^{[5
]}

Pretta, Andrea ^{[6
,7
]}

Deias, Giulia ^{[6
,7
]}

Willard-Gallo, Karen ^{[8
]}

Parra, Hector Soto ^{[9
]}

Saba, Luca ^{[3
]}

Scartozzi, Mario ^{[6
,7
]}

Wekking, Demi ^{[10
]}

Kok, Marleen ^{[10
,11
,12
]}

Aiello, Marco Maria ^{[13
]}

Solinas, Cinzia ^{[14
]}

机构：

[1] Univ Hosp Policlin GRodol San Marco, Med Oncol, I-95123 Catania, Italy

[2] Netherlands Canc Inst, Dept Med Oncol, Amsterdam, Netherlands

[3] Univ Cagliari, Dept Radiol, AOU Cagliari, Cagliari, Italy

[4] Azienda Tutela Salute Sardegna, Via Enrico Costa 57, Sassari, Italy

[5] Osped Maggiore Policlin, Fdn IRCCS CaGranda, Oncol Unit, I-20122 Milan, Italy

[6] Univ Hosp, Med Oncol Unit, Cagliari, Italy

[7] Univ Cagliari, Cagliari, Italy

[8] Inst Jules Bordet, Mol Immunol Unit, Blvd Waterloo 121, Brussels, Belgium

[9] Azienda Osped Univ Policlin G Rodol S Marco, Med Oncol, I-95123 Catania, Italy

[10] Univ Amsterdam, Acad Med Ctr, Amsterdam UMC, Amsterdam, Netherlands

[11] Netherlands Canc Inst, Dept Med Oncol, NL-1066 CX Amsterdam, North Holland, Netherlands

[12] Netherlands Canc Inst, Div Tumor Biol & Immunol, Amsterdam, Netherlands

[13] Azienda Osped Univ Policlin San Marco, Via St Sofia 78, Catania, Italy

[14] AOU Cagliari Policlin Duilio Casula, Med Oncol, Cagliari, Italy

来源：

SEMINARS IN ONCOLOGY | 2023年 / 50卷 / 06期

关键词：

Immune checkpoint inhibitors; Endocrine immune-related adverse events; Primary adrenal insufficiency; ICI-induced PAI; Radiological assessment; ADDISONS-DISEASE; ADVERSE EVENTS; MANAGEMENT; DIAGNOSIS; DYSFUNCTION; UPDATE;

D O I：

10.1053/j.seminoncol.2023.11.003

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

Immune checkpoint inhibitors (ICI) have become a cornerstone in medical oncology, with evolving therapeutic strategies and applications. These monoclonal antibodies, designed to enhance immune responses, have revealed a spectrum of immune -related adverse events (irAEs). While many irAEs exhibit favorable responses to corticosteroid or immunosuppressive therapy, most ICI -related endocrinopathies necessitate lifelong replacement therapy and pose significant clinical challenges. Adrenal insufficiency (AI), a noteworthy endocrine irAE, can manifest as primary AI (PAI) or secondary AI (SAI), resulting from adrenal or pituitary gland dysfunction, respectively. ICI -induced AI, albeit relatively infrequent, occurs in 1-2% of patients receiving single -agent anti -Programmed Death-1/Programmed Death-Ligand 1 (PD-1/PD-L1) or Cytotoxic T -Lymphocyte Antigen 4 (CTLA-4) therapies and in a higher range of 4-9% when ICIs are used in combinations. Recognizing and addressing ICI -induced PAI is crucial, as it often presents with acute and potentially life -threatening symptoms, especially considering the expanding use of ICI therapy. This review provides an updated overview of ICI -induced PAI, exploring its clinical, diagnostic, and radiological aspects.

引用

页码：144 / 148

页数：5