Vnitr Lek 2016, 62(Suppl 3):45-49

Endocrine complications of modern cancer therapy

Jan Čáp

IV. interní hematologická klinika LF UK a FN Hradec Králové

Treatment with tyrosine kinase inhibitors leads to thyroid dysfunction in up to one half of treated patients, hypothyroidism being the most common. It is caused by destructive thyroiditis, impaired transport of T₄ into the cell and deiodinase induction. Bexarotene is a nuclear retinoid X receptor agonist. Its application is accompanied with central hypothyroidism and hypertriglyceriaemia in virtually all patients and it also increases thyroxin metabolism. Autoimmune endocrine side effects are common in cancer immunotherapy. Cytokines (interpheron α and interleukin 2) cause autoimmune thyroiditis in 2-10 % of treated patients. Therapy with immune checkpoints inhibitors is connected with a variety of immune-related adverse events (irAE). Endocrine irAE include hypophysitis and thyroiditis during treatment with monoclonal antibodies against CTLA4 and thyroid dysfunction during therapy with antibody against CD1 receptor and its ligand. Knowledge, early recognition and management of these side effects is crucial.

Keywords: bexarotene; endocrine complication; hypophysitis; immune checkpoint inhibitors; immunotherapy

Received: August 22, 2016; Accepted: September 1, 2016; Published: June 1, 2016  Show citation