Case Report
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İmmün Checkpoint İnhibitörlerinin Nadir Yan Etkisi: Adrenal Yetmezlik

Year 2025, Volume: 22 Issue: 1, 195 - 198, 26.03.2025
https://doi.org/10.35440/hutfd.1546792

Abstract

Amaç: İmmün kontrol noktası inhibitörleri immun yanıtı düzenleyen hücre zar proteinleridir. Küçük hücreli dışı akciğer kanseri, renal hücreli karsinom, melanom ve diğer bazı tümör tiple-rinin tedavisinde kullanılmaktadır. Dermatolojik, gastrointestinal, hepatik, endokrin ve diğer sistemleri etkilerler. Halsizlik, yorgunluk, bulantı ve kusma şikâyetleri ile başvuran bir hasta-da nivolumabın neden olduğu adrenal yetmezlik olgusunu sunuyoruz.

References

  • 1. Ansell SM, Lesokhin AM, Borrello I, Halwani A, Scott EC, Gutierrez M, et al. PD-1 blockade with nivolumab in relapsed or refractory Hodgkin’s lymphoma. N Engl J Med. 2015;372:311- 319.
  • 2. Bellmunt J, de Wit R, Vaughn DJ, Fradet Y, Lee JL, Fong L, et al. Pembrolizumab as Second-Line Therapy for Advanced Urot-helial Carcinoma. N Engl J Med. 2017;376:1015- 1026.
  • 3. Emens LA, Ascierto PA, Darcy PK, Demaria S, Eggermont AMM, Redmond WL, et al. Cancer immunotherapy: opportuni-ties and challenges in the rapidly evolving clinical landscape. Eur J Cancer. 2017;81:116-129.
  • 4. Hargadon KM, Johnson CE, Williams CJ. Immune checkpoint blockade therapy for cancer: An overview of FDA-approved immune checkpoint inhibitors. Int Immunopharmacol. 2018;62:29-39.
  • 5. Markham A, Duggan S. Cemiplimab: first global approval. Drugs. 2018;78:1841-1846
  • 6. Psimaras D, Velasco R, Birzu C, Tamburin S, Lustberg M, Bruna J, et al. Immune checkpoint inhibitors‐induced neuro-muscular toxicity: from pathogenesis to treatment. J Peripher Nerv Syst. 2019 Oct:24 Suppl 2:S74-S85.
  • 7. Chen DY, Huang WK, Wu VCC, Chang WC, Chen JS, Chuang CK, et al. Cardiovascular toxicity of immune checkpoint inhibi-tors in cancer patients: A review when cardiology meets im-muno-oncology.J Formos Med Assoc. 2020 Oct;119(10):1461-1475.
  • 8. Cappelli LC, Gutierrez AK, Bingham CO 3rd, Shah AA. Rheu-matic and Musculoskeletal Immune-Related Adverse Events Due to Immune Checkpoint Inhibitors: A Systematic Review of the Literature. A Arthritis Care Res (Hoboken). 2017;69:1751-1763.
  • 9. Puzanov I, Diab A, Abdallah K, Bingham CO 3rd, Brogdon C, Dadu R, et al. Managing toxicities associated with immune checkpoint inhibitors: consensus recommendations from the Society for Immunotherapy of Cancer (SITC) Toxicity Manage-ment Working Group. J Immunother Cancer. 2017;5:95.
  • 10. Weber JS, Hodi FS, Wolchok JD, Topalian SL, Schadendorf D, Larkin J, et al. Safety profile of nivolumab monotherapy: A pooled analysis of patients with advanced melanoma. J Clin Oncol (2017) 35(7):785–92.
  • 11. Wright JJ, Powers AC, Johnson DB. Endocrine toxicities of immune checkpoint inhibitors. Nat Rev Endocrinol. 2021 Jul;17(7):389-399.
  • 12. De Filette J, Andreescu CE, Cools F, Bravenboer B, Velke-niers B. A Systematic Review and Meta-Analysis of Endocrine-Related Adverse Events Associated with Immune Checkpoint Inhibitors. Horm Metab Res 2019;51:145–56.
  • 13. Barroso-Sousa R, Barry WT, Garrido-Castro AC, Hodi FS, Min L, Krop LE, et al. Incidence of endocrine dysfunction fol-lowing the use of different immune checkpoint inhibitor regi-mens: a systematic review and meta-analysis. JAMA Oncol. 2018;4:173–182.
  • 14. Haissaguerre M, Hescot S, Bertherat J, Chabre O. Expert opinions on adrenal complications in immunotherapy. Ann Endocrinol (Paris). 2018 Oct;79(5):539-544.
  • 15. Melmed S, Koening R, Rosen CJ, Auchus RJ, Goldfine AB. Williams Textbook of Endocrinology 15th edition. Philadelphia, PA: Elsevier; 2020. The Adrenal Cortex - Chapter 13; pp. 514–515.

Rare Side Effect of Immune Checkpoint Inhibitors: Adrenal Insufficiency

Year 2025, Volume: 22 Issue: 1, 195 - 198, 26.03.2025
https://doi.org/10.35440/hutfd.1546792

Abstract

Summary
Immune checkpoint inhibitors are cell membrane proteins that regulate the immune response. It is used in the treatment of non-small cell lung cancer, renal cell carcinoma, melanoma and some other tumor types. They affect the dermatological, gastrointestinal, hepatic, endocrine and other systems. We present a case of adrenal insufficiency caused by nivolumab in a patient presenting with complaints of weakness, fatigue, nausea and vomiting.

References

  • 1. Ansell SM, Lesokhin AM, Borrello I, Halwani A, Scott EC, Gutierrez M, et al. PD-1 blockade with nivolumab in relapsed or refractory Hodgkin’s lymphoma. N Engl J Med. 2015;372:311- 319.
  • 2. Bellmunt J, de Wit R, Vaughn DJ, Fradet Y, Lee JL, Fong L, et al. Pembrolizumab as Second-Line Therapy for Advanced Urot-helial Carcinoma. N Engl J Med. 2017;376:1015- 1026.
  • 3. Emens LA, Ascierto PA, Darcy PK, Demaria S, Eggermont AMM, Redmond WL, et al. Cancer immunotherapy: opportuni-ties and challenges in the rapidly evolving clinical landscape. Eur J Cancer. 2017;81:116-129.
  • 4. Hargadon KM, Johnson CE, Williams CJ. Immune checkpoint blockade therapy for cancer: An overview of FDA-approved immune checkpoint inhibitors. Int Immunopharmacol. 2018;62:29-39.
  • 5. Markham A, Duggan S. Cemiplimab: first global approval. Drugs. 2018;78:1841-1846
  • 6. Psimaras D, Velasco R, Birzu C, Tamburin S, Lustberg M, Bruna J, et al. Immune checkpoint inhibitors‐induced neuro-muscular toxicity: from pathogenesis to treatment. J Peripher Nerv Syst. 2019 Oct:24 Suppl 2:S74-S85.
  • 7. Chen DY, Huang WK, Wu VCC, Chang WC, Chen JS, Chuang CK, et al. Cardiovascular toxicity of immune checkpoint inhibi-tors in cancer patients: A review when cardiology meets im-muno-oncology.J Formos Med Assoc. 2020 Oct;119(10):1461-1475.
  • 8. Cappelli LC, Gutierrez AK, Bingham CO 3rd, Shah AA. Rheu-matic and Musculoskeletal Immune-Related Adverse Events Due to Immune Checkpoint Inhibitors: A Systematic Review of the Literature. A Arthritis Care Res (Hoboken). 2017;69:1751-1763.
  • 9. Puzanov I, Diab A, Abdallah K, Bingham CO 3rd, Brogdon C, Dadu R, et al. Managing toxicities associated with immune checkpoint inhibitors: consensus recommendations from the Society for Immunotherapy of Cancer (SITC) Toxicity Manage-ment Working Group. J Immunother Cancer. 2017;5:95.
  • 10. Weber JS, Hodi FS, Wolchok JD, Topalian SL, Schadendorf D, Larkin J, et al. Safety profile of nivolumab monotherapy: A pooled analysis of patients with advanced melanoma. J Clin Oncol (2017) 35(7):785–92.
  • 11. Wright JJ, Powers AC, Johnson DB. Endocrine toxicities of immune checkpoint inhibitors. Nat Rev Endocrinol. 2021 Jul;17(7):389-399.
  • 12. De Filette J, Andreescu CE, Cools F, Bravenboer B, Velke-niers B. A Systematic Review and Meta-Analysis of Endocrine-Related Adverse Events Associated with Immune Checkpoint Inhibitors. Horm Metab Res 2019;51:145–56.
  • 13. Barroso-Sousa R, Barry WT, Garrido-Castro AC, Hodi FS, Min L, Krop LE, et al. Incidence of endocrine dysfunction fol-lowing the use of different immune checkpoint inhibitor regi-mens: a systematic review and meta-analysis. JAMA Oncol. 2018;4:173–182.
  • 14. Haissaguerre M, Hescot S, Bertherat J, Chabre O. Expert opinions on adrenal complications in immunotherapy. Ann Endocrinol (Paris). 2018 Oct;79(5):539-544.
  • 15. Melmed S, Koening R, Rosen CJ, Auchus RJ, Goldfine AB. Williams Textbook of Endocrinology 15th edition. Philadelphia, PA: Elsevier; 2020. The Adrenal Cortex - Chapter 13; pp. 514–515.
There are 15 citations in total.

Details

Primary Language English
Subjects Gastroenterology and Hepatology
Journal Section Case Report
Authors

Ramazan Yolacan 0000-0002-9427-5341

Bekir Kaya 0000-0002-3683-191X

Ali Üzel 0000-0002-2004-2094

Ümit Karabulut 0000-0003-3126-2129

Feyzullah Uçmak 0000-0002-2677-3971

Muhsin Kaya 0000-0002-7178-360X

Early Pub Date March 24, 2025
Publication Date March 26, 2025
Submission Date September 11, 2024
Acceptance Date January 28, 2025
Published in Issue Year 2025 Volume: 22 Issue: 1

Cite

Vancouver Yolacan R, Kaya B, Üzel A, Karabulut Ü, Uçmak F, Kaya M. Rare Side Effect of Immune Checkpoint Inhibitors: Adrenal Insufficiency. Harran Üniversitesi Tıp Fakültesi Dergisi. 2025;22(1):195-8.

Harran Üniversitesi Tıp Fakültesi Dergisi  / Journal of Harran University Medical Faculty