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Endocrine adverse events of immune checkpoint inhibitors: results of a single-center study

https://doi.org/10.47093/22187332.2019.4.4-11

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Abstract

Immune checkpoint inhibitors (ICPIs) agents can cause endocrine immune-related adverse events (irAEs).

Aim. Determine the incidence, time of onset and risk factors of endocrine irAEs in cancer patients treated with anti-PD1 and anti-CTLA-4 immunotherapy.

Materials and methods. This is a retrospective single-center study that included 61 patients aged 28 to 81 years with diagnosed cancer of the lungs, ovaries, esophagus, stomach, bladder, kidney, and pleural mesothelioma. 44 (72%) patients received anti-PDL1/anti-PD1 monotherapy and 17 (28%) received a combination of anti-PD1 + anti-CTLA-4. Calculated: odds ratio (OR) and 95% confidence interval (CI).

Results. The incidence of endocrine irAEs was 23% (14 patients): thyroiditis (13%), hypophysitis (8%), adrenal insufficiency and diabetes mellitus (2–3%). IrAEs occurred in 9 (20%) patients with monotherapy and in 5 (35%) patients when using a combination of drugs (p=0.318). The average time of onset of irAEs did not differ depending on the applied regimen and amounted to 6 [4–18] weeks. Symptomatic irAEs developed in 2 (13%) patients. Discontinuation of ICPI therapy due to irAE was not required in any case. Risk factors: age younger than 61 years old – OR 4.4 (95% CI 1.198–16.242), female OR 2.4 (95% CI 0.67–8.591), presence of stage IV disease – OR 2.4 (95% CI 0.689–8.362), combination therapy OR 1.855 (95% CI 0.548–6.277), previous endocrine pathology – OR 0.813 (95% CI 0.152–4.356).

Conclusions. The incidence of endocrine irAEs when using ICPI is 23%. Thyroiditis and hypophysitis develop more often. The odds are higher in patients younger than 61 years. In most cases, irAEs are not symptomatic and do not require discontinuation of ICPI therapy.

About the Authors

E. V. Poddubskaya
Sechenov First Moscow State Medical University (Sechenov University)
Russian Federation

Elena V. Poddubskaya, PhD, Deputy Director of Clinical Center for Oncology

Moscow



M. I. Sekacheva
Sechenov First Moscow State Medical University (Sechenov University)
Russian Federation

Marina I. Sekacheva, DMSc, Professor, Director of the Institute for Personalized Medicine, Director of the Center for Personalized Oncology Sechenov OncoTarget

Moscow



A. A. Guryanova
Sechenov First Moscow State Medical University (Sechenov University)
Russian Federation

Anastasia A. Guryanova, 5th year student of the International School "Medicine of the Future" of Biomedical Science & Technology Park

8/2 Trubetskaya st., Moscow, 119991
Tel.: +7 (927) 173-00-35 



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ISSN 2218-7332 (Print)
ISSN 2658-3348 (Online)