[Endocrinologic side effects of oncologic treatment with anti-CTLA-4-antibodies].
New immune-modulating treatments like the anti-CTLA-4-antibodies-based therapies are increasingly used in medical oncology. The action of Ipilimumab, a monoclonal anti-CTLA-4-antibody used for the treatment of metastasized melanoma and other solid tumors, is well documented. Blocking the CTLA-4-receptors on lymphocytes leads to T-cell activation and hence reduction of the tumor-mediated immunotolerance. This mechanism constitutes the basis of the antiproliferative effects but is also responsible for a spectrum of specific adverse events (immune-related adverse events, IRAE). IRAE of the endocrine system comprise hypophysitis, thyroiditis and adrenalitis. Especially adrenal insufficiency can be fatal when not diagnosed and treated. Symptoms often are unspecific and early diagnosis and targeted treatment are crucial. We present a case report and summarize - based upon the current literature - the diagnosis and treatment of endocrinologic IRAEs.
Departement Medizin, Klinik für Endokrinologie, Diabetologie und Klinische Ernährung, Luzerner Kantonsspital, Luzern.
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S
Fischli
Departement Medizin, Klinik für Endokrinologie, Diabetologie und Klinische Ernährung, Luzerner Kantonsspital, Luzern.
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S
Allelein
Departement Medizin, Klinik für Medizinische Onkologie, Luzerner Kantonsspital, Luzern.
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T
Zander
Departement Medizin, Klinik für Endokrinologie, Diabetologie und Klinische Ernährung, Luzerner Kantonsspital, Luzern.
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C
Henzen
D000307:Adrenal Gland Diseases / Q000139:chemically induced / Q000175:diagnosis; D000911:Antibodies, Monoclonal / Q000009:adverse effects* / Q000627:therapeutic use*; D001932:Brain Neoplasms / Q000188:drug therapy* / Q000556:secondary*; D060908:CTLA-4 Antigen / Q000037:antagonists & inhibitors* / Q000276:immunology; D003092:Colitis / Q000139:chemically induced / Q000175:diagnosis; D005500:Follow-Up Studies; D006801:Humans; D006980:Hyperthyroidism / Q000139:chemically induced / Q000175:diagnosis; D007018:Hypopituitarism / Q000139:chemically induced* / Q000175:diagnosis; D000074324:Ipilimumab; D008113:Liver Neoplasms / Q000188:drug therapy* / Q000556:secondary*; D008175:Lung Neoplasms / Q000188:drug therapy* / Q000556:secondary*; D008297:Male; D008545:Melanoma / Q000188:drug therapy* / Q000556:secondary*; D008875:Middle Aged; D012878:Skin Neoplasms / Q000188:drug therapy*; D013966:Thyroiditis / Q000139:chemically induced / Q000175:diagnosis
D000911:Antibodies, Monoclonal; D060908:CTLA-4 Antigen; D000074324:Ipilimumab