Management of immune-related adverse events in endocrine organs induced by immune checkpoint inhibitors: clinical guidelines of the Japan Endocrine Society
Management of immune-related adverse events in endocrine organs induced by immune checkpoint inhibitors: clinical guidelines of the Japan Endocrine Society
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DOI：
10.1507/endocrj.ej19-0163
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发表时间：
2019-01-01
影响因子：
2
通讯作者：
Akamizu, Takashi
中科院分区：
文献类型：
--
作者：
Arima, Hiroshi;Iwama, Shintaro;Akamizu, Takashi
免疫检查点抑制剂（ICIs）已成为晚期恶性肿瘤的一种有前景的治疗方法。然而，这些药物可在多个器官中诱发免疫相关不良事件（irAE），包括皮肤、胃肠道、肝脏、肌肉、神经和内分泌器官。内分泌 irAE 包括垂体功能减退、原发性肾上腺皮质功能不全、甲状腺功能障碍、甲状旁腺功能减退和 1 型糖尿病。这些情况有可能导致危及生命的后果，例如肾上腺危象、甲状腺危象、严重低钙血症和糖尿病酮症酸中毒。因此，内分泌学家和肿瘤学家必须了解每种内分泌 irAE 的临床特征，以便对其进行适当的管理。本意见书提供了日本内分泌学会和日本糖尿病学会关于 ICI 引起的内分泌 irAE 管理的指南。
Immune checkpoint inhibitors (ICIs) have become a promising treatment for advanced malignancies. However, these drugs can induce immune-related adverse events (irAEs) in several organs, including skin, gastrointestinal tract, liver, muscle, nerve, and endocrine organs. Endocrine irAEs comprise hypopituitarism, primary adrenal insufficiency, thyroid dysfunction, hypoparathyroidism, and type 1 diabetes mellitus. These conditions have the potential to lead to life-threatening consequences, such as adrenal crisis, thyroid storm, severe hypocalcemia, and diabetic ketoacidosis. It is therefore important that both endocrinologists and oncologists understand the clinical features of each endocrine irAE to manage them appropriately. This opinion paper provides the guidelines of the Japan Endocrine Society and in part the Japan Diabetes Society for the management of endocrine irAEs induced by ICIs.