Immunotherapy-related hypothyroidism: mechanisms and management

Abstract

Immunotherapy has recently emerged as an important tool in the treatment of various malignancies. However, increased use of immune checkpoint inhibitors (ICIs) has brought attention to the associated adverse events, with hypothyroidism being a noteworthy complication. This review explores the mechanisms underlying immunotherapy-induced hypothyroidism and its management. The importance of distinguishing between primary and secondary hypothyroidism in the context of immunotherapy is emphasized, as timely intervention is critical in preventing adrenal crises. Not all patients with immune-related hypothyroidism are treated with levothyroxine. Additionally, only in severe toxicities, ICIs are hold. So, determining the management strategy is important for endocrinologists and oncologists. Therefore, multidisciplinary approach is crucial for immune-related adverse reactions (irAEs). In conclusion, this review provides a comprehensive overview of immunotherapy-induced hypothyroidism, encompassing its mechanisms, diagnostic considerations, and management strategies. By enhancing our understanding of this adverse event, endocrinologists can manage potential complications associated with immunotherapy.