Novosad S.V., Martirosian N.S., Khachaturov M.V., Utyashev I.A., Rogava E.T., Petunina N.A.Immune checkpoint inhibitors: features of endocrine immune-related adverse events. Head and neck.Russian Journal. 2025;13(1):63–69
DOI: https://doi.org/10.25792/HN.2025.13.1.63-69
Objective: to analyze hormonal and metabolic risk factors that contribute to the development of immune-mediatedadverse endocrine events during therapy with immune checkpoint inhibitors (ICIs).
Material and methods. Our retrospective single-center study included 65 patients aged 33 to 90 years whoreceived immunotherapy with anti-PD-1, anti-PD-L1 and anti-CTLA4 monoclonal antibodies for various oncologicaldiseases. Before and during the treatment, clinical, hormonal and metabolic parameters (body mass index (BMI),the presence of concomitant diseases (impaired glucose tolerance (IGT), impaired fasting glycemia (IFG), type 2diabetes mellitus (DM 2), metabolic syndrome (MS), obesity, hypertension, coronary heart disease (CHD), chronicheart failure (CHF), dyslipidemia) were assessed. The impact on the incidence of immune-mediated endocrineadverse events (irEAE) was assessed by calculating the odds ratio (OR) at a 95% confidence interval.
Results. During the follow-up period, 21 (32.3%) patients were diagnosed with irAE, including: hepatitis, pruritus,rash, diarrhea, arthralgia, pneumonitis, vitiligo, IGT. At the same time, endocrine-related irAEs were detected in18 (27,7%) patients: autoimmune thyroiditis resulting in hypothyroidism was detected in 9 (13.8%) patients, type 2diabetes in 6 (9.2%) patients, hypophysitis in 1 (1.5%) patient, primary adrenal insufficiency developed in 2 (3.1%)patients. During immunotherapy, hyperglycemia progression was noted: a significant increase in glucose levelswas revealed after the initiation of therapy (p=0.008). Impaired glucose tolerance developed in 8 (12.3%) patients.The influence of BMI, glucose and metabolic syndrome on the risk of irEAEs was insignificant (OR=1.227, 95% CI0.876–1.719, OR=1.263, 95% CI 0.891–1.792, OR=1.19 95% CI 0.83–1.706 respectively).
Conclusion. A prospective study is needed to clarify the mechanisms of the influence of obesity and metabolicsyndrome on the risk of developing adverse immune-mediated events and patient survival during ICI therapy.
Keywords: anticancer immunotherapy, immune checkpoint inhibitors, anti-PD-1 mAbs, anti-PD-L1 mAbs, anti-CTLA4 mAbs, immune-mediated adverse events, thyroiditis, hypophysitis, diabetes mellitus, adrenal insufficiency
Conflicts of interest. The authors have no conflicts of interest to declare.
Funding. There was no funding for this study