Immune checkpoint inhibitor combination therapies very frequently induce secondary adrenal insufficiency

Abstract Immune checkpoint inhibitors (ICIs) are potent therapeutic options for many types of advanced cancer. The expansion of ICIs use however has led to an increase in immune-related adverse events (irAEs). Secondary adrenal insufficiency (AI) can be life-threatening especially in patients with d...

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Autores principales:	Katsunori Manaka, Junichiro Sato, Maki Takeuchi, Kousuke Watanabe, Hidenori Kage, Taketo Kawai, Yusuke Sato, Takuya Miyagawa, Daisuke Yamada, Haruki Kume, Shinichi Sato, Takahide Nagase, Taroh Iiri, Masaomi Nangaku, Noriko Makita
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/17fdf79d6b164cec9a920dc3a38ae5d0
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spelling	oai:doaj.org-article:17fdf79d6b164cec9a920dc3a38ae5d02021-12-02T18:24:54ZImmune checkpoint inhibitor combination therapies very frequently induce secondary adrenal insufficiency10.1038/s41598-021-91032-62045-2322https://doaj.org/article/17fdf79d6b164cec9a920dc3a38ae5d02021-06-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-91032-6https://doaj.org/toc/2045-2322Abstract Immune checkpoint inhibitors (ICIs) are potent therapeutic options for many types of advanced cancer. The expansion of ICIs use however has led to an increase in immune-related adverse events (irAEs). Secondary adrenal insufficiency (AI) can be life-threatening especially in patients with delayed diagnosis. We retrospectively investigated secondary AI in ICI-treated patients. A total of 373 cancer patients treated with ICIs were included and evaluated. An adrenocorticotropic hormone (ACTH) deficiency was described in 13 patients. Among 24 patients with a combination of nivolumab and ipilimumab therapy, 7 patients (29%) developed secondary AI in a median time of 8 weeks during the combination therapy and 2 of 15 patients (13%) developed isolated ACTH deficiency during maintenance nivolumab monotherapy following the combination therapy. More than half of the patients (4/7) with a combination therapy-induced multiple anterior hormone deficiencies was diagnosed as secondary AI based on regular ACTH and cortisol tests with slight subjective symptoms. Secondary AI can arise frequently and rapidly in cancer patients receiving a combination ICI therapy, and thus we speculate active surveillance of AI using regular ACTH and cortisol tests during the combination therapy might be useful for avoiding life-threatening conditions due to secondary AI.Katsunori ManakaJunichiro SatoMaki TakeuchiKousuke WatanabeHidenori KageTaketo KawaiYusuke SatoTakuya MiyagawaDaisuke YamadaHaruki KumeShinichi SatoTakahide NagaseTaroh IiriMasaomi NangakuNoriko MakitaNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-10 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Katsunori Manaka Junichiro Sato Maki Takeuchi Kousuke Watanabe Hidenori Kage Taketo Kawai Yusuke Sato Takuya Miyagawa Daisuke Yamada Haruki Kume Shinichi Sato Takahide Nagase Taroh Iiri Masaomi Nangaku Noriko Makita Immune checkpoint inhibitor combination therapies very frequently induce secondary adrenal insufficiency
description	Abstract Immune checkpoint inhibitors (ICIs) are potent therapeutic options for many types of advanced cancer. The expansion of ICIs use however has led to an increase in immune-related adverse events (irAEs). Secondary adrenal insufficiency (AI) can be life-threatening especially in patients with delayed diagnosis. We retrospectively investigated secondary AI in ICI-treated patients. A total of 373 cancer patients treated with ICIs were included and evaluated. An adrenocorticotropic hormone (ACTH) deficiency was described in 13 patients. Among 24 patients with a combination of nivolumab and ipilimumab therapy, 7 patients (29%) developed secondary AI in a median time of 8 weeks during the combination therapy and 2 of 15 patients (13%) developed isolated ACTH deficiency during maintenance nivolumab monotherapy following the combination therapy. More than half of the patients (4/7) with a combination therapy-induced multiple anterior hormone deficiencies was diagnosed as secondary AI based on regular ACTH and cortisol tests with slight subjective symptoms. Secondary AI can arise frequently and rapidly in cancer patients receiving a combination ICI therapy, and thus we speculate active surveillance of AI using regular ACTH and cortisol tests during the combination therapy might be useful for avoiding life-threatening conditions due to secondary AI.
format	article
author	Katsunori Manaka Junichiro Sato Maki Takeuchi Kousuke Watanabe Hidenori Kage Taketo Kawai Yusuke Sato Takuya Miyagawa Daisuke Yamada Haruki Kume Shinichi Sato Takahide Nagase Taroh Iiri Masaomi Nangaku Noriko Makita
author_facet	Katsunori Manaka Junichiro Sato Maki Takeuchi Kousuke Watanabe Hidenori Kage Taketo Kawai Yusuke Sato Takuya Miyagawa Daisuke Yamada Haruki Kume Shinichi Sato Takahide Nagase Taroh Iiri Masaomi Nangaku Noriko Makita
author_sort	Katsunori Manaka
title	Immune checkpoint inhibitor combination therapies very frequently induce secondary adrenal insufficiency
title_short	Immune checkpoint inhibitor combination therapies very frequently induce secondary adrenal insufficiency
title_full	Immune checkpoint inhibitor combination therapies very frequently induce secondary adrenal insufficiency
title_fullStr	Immune checkpoint inhibitor combination therapies very frequently induce secondary adrenal insufficiency
title_full_unstemmed	Immune checkpoint inhibitor combination therapies very frequently induce secondary adrenal insufficiency
title_sort	immune checkpoint inhibitor combination therapies very frequently induce secondary adrenal insufficiency
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/17fdf79d6b164cec9a920dc3a38ae5d0
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Immune checkpoint inhibitor combination therapies very frequently induce secondary adrenal insufficiency

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