Multimodality imaging of endocrine immune related adverse events: a primer for radiologists

Alessandrino, Francesco; Shah, Hina; Ramaiya, Nikhil H.

doi:10.1016/j.clinimag.2017.12.014

Cited by 23 publications

(35 citation statements)

References 69 publications

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“…Laboratory and imaging studies are consistent with hypophysitis if there is deficiency of at least 1 pituitary hormone with magnetic resonance imaging (MRI) abnormality or if there is a deficiency of ≥2 pituitary hormones in the presence of symptoms . MRI findings may include diffuse pituitary enlargement, enlargement of the infundibulum, and homogeneous or heterogeneous pituitary enhancement after gadolinium administration, which may precede laboratory or clinical findings …”

Section: Checkpoint Inhibitorsmentioning

confidence: 99%

“…11 MRI findings may include diffuse pituitary enlargement, enlargement of the infundibulum, and homogeneous or heterogeneous pituitary enhancement after gadolinium administration, which may precede laboratory or clinical findings. 72 Adrenal insufficiency secondary to ICI-induced hypophysitis is usually permanent and requires lifelong hormone replacement. 71 Recovery of secondary hypothyroidism and hypogonadism has been described with frequency varying from 6% to 64% and 11% to 57%, respectively.…”

Section: Pituitary Toxicitymentioning

confidence: 99%

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A review of cancer immunotherapy toxicity

Kennedy

Salama

2020

CA A Cancer J Clinicians

839

699

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Cancer immunotherapies, including checkpoint inhibitors and adoptive cell therapy, manipulate the immune system to recognize and attack cancer cells. These therapies have the potential to induce durable responses in multiple solid and hematologic malignancies and thus have transformed treatment algorithms for numerous tumor types. Cancer immunotherapies lead to unique toxicity profiles distinct from the toxicities of other cancer therapies, depending on their mechanism of action. These toxicities often require specific management, which can include steroids and immune‐modulating therapy and for which consensus guidelines have been published. This review will focus on the toxicities of checkpoint inhibitors and chimeric antigen receptor T cells, including pathophysiology, diagnosis, and management.

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Section: Checkpoint Inhibitorsmentioning

confidence: 99%

Section: Pituitary Toxicitymentioning

confidence: 99%

A review of cancer immunotherapy toxicity

Kennedy

Salama

2020

CA A Cancer J Clinicians

839

699

View full text Add to dashboard Cite

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“…Ultrasound is the tool of choice in this setting. Thyroid enlargement with heterogeneous and hypoechoic parenchyma, often with a nodular or pseudonodular pattern, may be observed [55]. An increased vascularity at colour-Doppler evaluation may be also found.…”

Section: Endocrine Toxicitiesmentioning

confidence: 99%

“…Hypophysitis can incidentally be detected by imaging in asymptomatic patients or before onset of symptoms. It presents as an enlarged hypophysis on brain CT or magnetic resonance imaging (MRI), or an 18 F-FDG-avid pituitary gland on PET/CT [46,54,55]. Any suspected hypophysitis requires an MRI of the pituitary gland to confirm the diagnosis and exclude mimickers such as metastasis and pituitary adenoma.…”

Section: Endocrine Toxicitiesmentioning

confidence: 99%

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Imaging of tumour response to immunotherapy

et al. 2020

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A wide range of cancer immunotherapy approaches has been developed including non-specific immune-stimulants such as cytokines, cancer vaccines, immune checkpoint inhibitors (ICIs), and adoptive T cell therapy. Among them, ICIs are the most commonly used and intensively studied. Since 2011, these drugs have received marketing authorisation for melanoma, lung, bladder, renal, and head and neck cancers, with remarkable and long-lasting treatment response in some patients. The novel mechanism of action of ICIs, with immune and T cell activation, leads to unusual patterns of response on imaging, with the advent of so-called pseudoprogression being more pronounced and frequently observed when compared to other anticancer therapies. Pseudoprogression, described in about 2-10% of patients treated with ICIs, corresponds to an increase of tumour burden and/or the appearance of new lesions due to infiltration by activated T cells before the disease responds to therapy. To overcome the limitation of response evaluation criteria in solid tumors (RECIST) to assess these specific changes, new imaging criteria-so-called immune-related response criteria and then immune-related RECIST (irRECIST)-were proposed. The major modification involved the inclusion of the measurements of new target lesions into disease assessments and the need for a 4-week re-assessment to confirm or not confirm progression. The RECIST working group introduced the new concept of "unconfirmed progression", into the irRECIST. This paper reviews current immunotherapeutic approaches and summarises radiologic criteria to evaluate new patterns of response to immunotherapy. Furthermore, imaging features of immunotherapy-related adverse events and available predictive biomarkers of response are presented.

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Evolving Role of the Oncology Nurse in the Care of Patients with Melanoma

Rubin¹

2019

Melanoma

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Multimodality imaging of endocrine immune related adverse events: a primer for radiologists

Cited by 23 publications

References 69 publications

A review of cancer immunotherapy toxicity

A review of cancer immunotherapy toxicity

Imaging of tumour response to immunotherapy

Evolving Role of the Oncology Nurse in the Care of Patients with Melanoma

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