Endocrine and Neurological Toxicities of Immunotherapies

Praxis (Bern 1994). 2023;112(3):178-183. doi: 10.1024/1661-8157/a003978.

Abstract

Immunotherapy has revolutionized cancer care but exposes patients to a new spectrum of complications that mimic autoimmune diseases, which are referred to as immune-related adverse events (irAEs). Endocrine complications are among the most common and involve nearly all endocrine tissues. Corticosteroids are not useful in endocrine irAEs, and definitive hormonal substitution is often indicated. Neurological irAEs can involve the central nervous system, the peripheral nervous system or the neuromuscular junction. Neurological irAEs are among the rarer complications but are associated with a higher morbidity and fatality. Therefore, prompt recognition and treatment are crucial. In this article, we discuss incidence, presentation, work-up, management, and common pitfalls in endocrine and neurological irAEs.

Keywords: Effets indésirables immuno-médiés; Immunotherapy; Immuntherapie; effets indésirables endocriniens immuno-médiés; effets indésirables neurologique immuno-médiés; endocrine immune-related adverse events; immune-related adverse events; immunvermittelte Nebenwirkungen; immunvermittelte endokrine Nebenwirkungen; immunvermittelte neurologische Nebenwirkungen; neurological immune-related adverse events.

MeSH terms

  • Autoimmune Diseases*
  • Humans
  • Immunotherapy* / adverse effects