Multinational Association of Supportive Care in Cancer (MASCC) 2020 clinical practice recommendations for the management of immune checkpoint inhibitor endocrinopathies and the role of advanced practice providers in the management of immune-mediated toxicities

• Published in: Supportive care in cancer 2020-12, Vol.28 (12), p.6175-6181
• Main Authors: Cooksley, Tim, Girotra, Monica, Ginex, Pamela, Gordon, Ruth Ann, Anderson, Ronald, Blidner, Ada, Choi, Jennifer, Dougan, Michael, Glezerman, Ilya, Gupta, Dipti, Johnson, Douglas, Shannon, Vickie R., Suarez-Almazor, Maria, Rapoport, Bernardo L.
• Format: Article
• Language: English
• Subjects: Cancer; Care and treatment; Clinical outcomes; Complications and side effects; CTLA-4 Antigen - antagonists & inhibitors; CTLA-4 Antigen - immunology; Cytotoxicity; Diabetes; Diagnosis; Drug therapy; Drug-Related Side Effects and Adverse Reactions - epidemiology; Drug-Related Side Effects and Adverse Reactions - therapy; Emergency medical care; Endocrine system; Endocrine System Diseases - chemically induced; Endocrine System Diseases - epidemiology; Endocrine System Diseases - therapy; History, 21st Century; Humans; Hyperglycemia; Hypothyroidism; Immune Checkpoint Inhibitors - adverse effects; Immune Checkpoint Inhibitors - therapeutic use; Immune system; Immunologic Factors - adverse effects; Immunologic Factors - therapeutic use; Immunotherapy - adverse effects; International Agencies - organization & administration; International Agencies - standards; Ipilimumab; Medical colleges; Medical Oncology - organization & administration; Medical Oncology - standards; Medicine; Medicine & Public Health; Multinational Association of Supportive Care in Cancer (MASCC) 2020 Clinical Practice Recommendations for the Management of Immune-mediated Adverse Events from Checkpoint Inhibitors; Neoplasms - epidemiology; Neoplasms - immunology; Neoplasms - therapy; Nursing; Nursing Research; Oncology; Pain Medicine; Palliative Care - organization & administration; Palliative Care - standards; Palliative Medicine - organization & administration; Palliative Medicine - standards; Patients; Physician's Role; Pituitary gland; Programmed Cell Death 1 Receptor - antagonists & inhibitors; Programmed Cell Death 1 Receptor - immunology; Rehabilitation Medicine; Severity of Illness Index; Societies, Medical - organization & administration; Societies, Medical - standards; Special Article; T cells; Thyroid diseases; Thyroid gland
• ISSN: 0941-4355; 1433-7339
• DOI: 10.1007/s00520-020-05709-1

Immune checkpoint inhibitors (ICIs) have emerged as the newest pillar of cancer treatment, transforming outcomes in melanoma and showing benefit in a range of malignancies. Immune-mediated toxicities, stemming from increased activity within the T cell lineage, range from asymptomatic or mild complications to those that are fulminant and potentially fatal. Immune-mediated endocrinopathies include hypophysitis, thyroiditis, and insulin-dependent diabetes mellitus. These presentations, which may be vague and non-specific, can be life-threatening if not diagnosed and treated appropriately. This review considers the work-up and management of immune-mediated endocrinopathies and also considers the role of advanced practice practitioners in the management of immune-mediated toxicities. These state-of-the-art MASCC recommendations represent a comprehensive overview of the management and clinical work-up in those in whom the diagnosis should be considered.