Immune checkpoint inhibitors in cancer therapy: The leading role of the endocrinologist

The endocrine, immune, and nervous systems have a close functional relation from the embryonic development until end of life, nevertheless this important homeostasis can be altered by any stressors such as infections, autoimmune diseases, neoplasms or medications.
 Immune checkpoint inhibitors (ICPi) relatively recently emerged promising treatment option for several cancers, including advanced melanoma, non–small cell lung cancer, renal carcinoma, colorectal cancer. ICPi target immune checkpoints, cytotoxic T-lymphocyte-associated protein 4 (CTLA-4), programmed death 1 (PD-1) its ligand (PD-L1). modulates system with aim eradicating cancer cells, but despite their acknowledged anti-cancer efficacy, they increase risk developing disorders. In fashion, same mechanisms that support tumor regression may favor autoantigen-mediated cytotoxicity production T-cell-dependent autoantibodies. Importantly, patients on develop endocrine adverse events, even after months years final dose ICPi, affecting wide variety glands. These events include hypophysitis, diabetes mellitus, hypo hyperthyroidism, and, adrenal insufficiency. Such toxicities complicate clinical course prognosis patients, increasing morbidity mortality if not promptly identified treated, life threatening irreversible.