Endocrine Abstracts

Aim: Baseline clinical and biochemical endocrine assessment at the start of immune checkpoint treatment and each treatment cycle is important given the treatable nature of it. Also given the improvements in survival of these patients necessitate further longterm screening. Our study was to look at various aspects of this screening with a view to improve our knowledge and also patient care.

Methods: Using an excel database, a retrospective data collection was performed for 31 patients receiving Ipilimumab and/or Pembrolizumab between 1^st January 2016 and 30^th September 2016 in Kent. We looked to see if tests for endocrine dysfunction (TSH, FT4, 9 am cortisol, pituitary functions) were carried out on a 3 weekly basis as per local guidelines and the outcomes of these results for 39 weeks following administration of the immune checkpoint inhibitor.

Outcomes/results: 25.81% of the patients developed endocrine complications following immune checkpoint therapy and the onset varied between 3 weeks and 36 weeks after the commencement. None of the patients with an endocrine abnormality underwent pituitary imaging and only 2 in 8 of the patients who developed an endocrine abnormality were referred to an endocrine team.

Conclusion: A high prevalence of endocrine dysfunction indicates the need for collaboration between the oncologists and endocrinologists with robust guidelines to be adhered to when prescribing an immune checkpoint inhibitor. If abnormalities are detected, a full pituitary screening (biochemistry and imaging) should be undertaken. The follow up period for endocrine function after administration of immune checkpoint inhibitors needs to be extended globally to at least 36 weeks.