Immunotherapy-induced endocrinopathies: Insights from the 2018 French Endocrine Society Guidelines

The management of cancer patients has changed due to the considerably more frequent use of immune checkpoint inhibitors (ICPI). However, the use of ICPI has a risk of side-effects, particularly endocrine toxicity. Since the indications for ICPI are constantly expanding due to their efficacy, it is important that endocrinologists and oncologists know how to look for this type of toxicity and how to treat it when it arises. In view of this, the French Endocrine Society initiated the formulation of a guidance document on ICPI-related endocrine toxicity. In this paper, we summarize the main insights of experts' opinions, from an oncologist viewpoint: initial screening, monitoring, emergency situations for which immediate management by the oncologist is crucial, as well as the roles of the interactions between oncologists and endocrinologists. These points will be detailed for each endocrinopathy, i.e., dysthyroidism, hypophysitis, fulminant diabetes and primary adrenal insufficiency. In each chapter, expert opinion will be given on the diagnosis, management and monitoring for each complication. Finally, the CTCAE (Common terminology criteria for adverse events) recommendations will be discussed in view of the relatively easy management of such endocrine side-effects