Introduction: Immune checkpoint inhibitors (ICIs) have revolutionised cancer treatment but are associated with agent-specific spectra of endocrine-related adverse events (irAEs). Data on prevalence of ICI-induced endocrinopathies in Indian populations remain limited. A study was conducted with an aim to determine the prevalence and spectrum of endocrinopathies resulting from ICI therapy in cancer patients at a tertiary care centre. Methods: This prospective cohort study included 100 adult cancer patients initiated on ICI therapy (anti-PD1 or PD-L1). Patients with pre-existing endocrinopathies or those diagnosed during baseline assessment were excluded. Comprehensive clinical, biochemical, and hormonal assessments were performed at baseline and during follow-up at 1, 2, 3, 6, 9, and 12 months. Endocrinopathies were diagnosed per standard criteria. Associations with demographic and clinical variables were analysed using Fisher’s exact test. Results: Endocrinopathies developed in 19% of participants during 12 months of follow-up. Primary hypothyroidism was most frequent (12%), followed by hypergonadotropic hypogonadism (3%), diabetes mellitus (2%), primary adrenal insufficiency (1%), and primary hyperparathyroidism (1%). The median age of those affected was 52.6 years, with a male predominance. Endocrinopathies occurred more commonly with PD-1 inhibitors compared to PD-L1 inhibitors. Hypertension was significantly associated with endocrinopathy development ( P = 0.044). Most endocrinopathies presented within the first six months of ICI therapy. Conclusion: ICI-induced endocrinopathies are prevalent among Indian cancer patients, with primary hypothyroidism being the most common. Early onset irAEs underscore the need for regular endocrine monitoring during and after ICI therapy.
Bishnoi et al. (Sun,) studied this question.