Endocrine side effects of immunotherapeutic drugs

O.S. Orlyk, A.V. Garnytska
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 OBJECTIVE. Based on the literature data, to investigate the possible side effects of immunotherapeutic drugs on the endocrine system.
 MATERIALS AND METHODS. Object: endocrine complications due to immunotherapy. Research method: review of literary sources.
 RESULTS. Among the manifestations of the endocrine system, the most common are thyroid dysfunction and diabetes mellitus. It is important to monitor the levels of thyroid-stimulating hormone (TSH), free T4, blood glucose and glycated hemoglobin for timely detection of endocrine pathology, prevention of unwanted complications and improvement of patients’ quality of life.
 CONCLUSIONS. Immunotherapy is vital for cancer patients. Given the possible development of various side effects, including those from the endocrine system, patients should monitor the main indicators of the thyroid gland (TSH, free T4) and carbohydrate metabolism (blood glucose, glycated hemoglobin) both before starting immunotherapy and during treatment. Patients with pre-existing endocrine disorders require more careful monitoring. It is possible that such patients, in the process of immunotherapy, may require correction of hypoglycemic drugs: speaking of diabetes mellitus, a possible option may be a dose correction of tableted antidiabetic drugs, a change in the therapy regimen or insulin therapy; in diseases of the thyroid gland, the doctor may suggest dose adjustment of thyroid drugs, ultrasound diagnostics and/or fine-needle aspiration biopsy of thyroid nodules.","PeriodicalId":13681,"journal":{"name":"Infusion & Chemotherapy","volume":null,"pages":null},"PeriodicalIF":0.0000,"publicationDate":"2023-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Infusion & Chemotherapy","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.32902/2663-0338-2023-3-43-48","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
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Abstract

BACKGROUND. Immunotherapy is an innovative approach to treatment that is changing the paradigm in oncology and is achieving significant results in the fight against malignant tumors including leukemia, melanoma, lung cancer, kidney cancer and many others. This treatment uses the power of the body’s immune system to fight cancer cells. Immunotherapy can lead to long-term remission or even complete disappearance of tumors in patients with certain types of cancer. The success of therapy depends on many factors, including the type of cancer and individual patient characteristics. As with any treatment, patients with immunotherapy may experience side effects. As a result of treatment with pembrolizumab (and other immunotherapeutic drugs), patients may develop endocrine disorders. The most common endocrine side effects include thyroiditis (which can lead to hyper- or hypothyroidism), inflammation of the parathyroid glands, hypophysitis, and diabetes mellitus. OBJECTIVE. Based on the literature data, to investigate the possible side effects of immunotherapeutic drugs on the endocrine system. MATERIALS AND METHODS. Object: endocrine complications due to immunotherapy. Research method: review of literary sources. RESULTS. Among the manifestations of the endocrine system, the most common are thyroid dysfunction and diabetes mellitus. It is important to monitor the levels of thyroid-stimulating hormone (TSH), free T4, blood glucose and glycated hemoglobin for timely detection of endocrine pathology, prevention of unwanted complications and improvement of patients’ quality of life. CONCLUSIONS. Immunotherapy is vital for cancer patients. Given the possible development of various side effects, including those from the endocrine system, patients should monitor the main indicators of the thyroid gland (TSH, free T4) and carbohydrate metabolism (blood glucose, glycated hemoglobin) both before starting immunotherapy and during treatment. Patients with pre-existing endocrine disorders require more careful monitoring. It is possible that such patients, in the process of immunotherapy, may require correction of hypoglycemic drugs: speaking of diabetes mellitus, a possible option may be a dose correction of tableted antidiabetic drugs, a change in the therapy regimen or insulin therapy; in diseases of the thyroid gland, the doctor may suggest dose adjustment of thyroid drugs, ultrasound diagnostics and/or fine-needle aspiration biopsy of thyroid nodules.
免疫治疗药物的内分泌副作用
背景。免疫疗法是一种创新的治疗方法,正在改变肿瘤学的范式,并在对抗恶性肿瘤(包括白血病、黑色素瘤、肺癌、肾癌和许多其他肿瘤)方面取得了重大成果。这种疗法利用人体免疫系统的力量来对抗癌细胞。免疫疗法可以导致某些类型癌症患者的肿瘤长期缓解甚至完全消失。治疗的成功取决于许多因素,包括癌症的类型和患者的个体特征。与任何治疗一样,免疫疗法的患者可能会出现副作用。由于使用派姆单抗(和其他免疫治疗药物)治疗,患者可能会出现内分泌紊乱。最常见的内分泌副作用包括甲状腺炎(可导致甲状腺功能亢进或减退)、甲状旁腺炎症、垂体炎和糖尿病。目标。结合文献资料,探讨免疫治疗药物对内分泌系统可能产生的副作用。 材料和方法。目的:探讨免疫治疗引起的内分泌并发症。研究方法:文献资料综述。 结果。在内分泌系统的表现中,最常见的是甲状腺功能障碍和糖尿病。监测促甲状腺激素(TSH)、游离T4、血糖及糖化血红蛋白水平,对及时发现内分泌病理,预防不良并发症,提高患者生活质量具有重要意义。 结论。免疫疗法对癌症患者至关重要。考虑到可能出现的各种副作用,包括内分泌系统的副作用,患者应在开始免疫治疗前和治疗过程中监测甲状腺(TSH,游离T4)和碳水化合物代谢(血糖,糖化血红蛋白)的主要指标。已有内分泌失调的患者需要更仔细的监测。这类患者在免疫治疗过程中可能需要纠正降糖药:说到糖尿病,一种可能的选择可能是调整片剂降糖药的剂量,改变治疗方案或胰岛素治疗;对于甲状腺疾病,医生可能建议调整甲状腺药物的剂量,超声诊断和/或甲状腺结节细针穿刺活检。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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