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Record W4383683290 · doi:10.58931/cdet.2023.1210

Endocrinopathies Associated with Immune Checkpoint Inhibitors

2023· article· en· W4383683290 on OpenAlexaff
Irena Druce

Bibliographic record

VenueCanadian Diabetes & Endocrinology Today · 2023
Typearticle
Languageen
FieldMedicine
TopicCancer Immunotherapy and Biomarkers
Canadian institutionsOttawa HospitalUniversity of Ottawa
Fundersnot available
KeywordsImmune systemMedicineAdverse effectImmune checkpointImmunologyImmunotherapyIpilimumabAutoimmunityCTLA-4OncologyInternal medicineT cell

Abstract

fetched live from OpenAlex

Immune checkpoint receptors are expressed by cells of the immune system and lead to reduced or absent function, which physiologically limits autoimmunity. These receptors are also exploited by malignant cells to maintain immune tolerance and evade destruction. Monoclonal antibodies targeting immune checkpoints have revolutionized oncology, with potential long-lasting clinical response, even in the setting of metastatic solid tumors. For example, in the past, metastatic melanoma signalled certain death; now, remission is possible.
 The primary targets of current pharmacotherapy are cytotoxic T-lymphocyte-associated protein 4 (CTLA-4) and the programmed cell death protein 1 (PD-1) and its ligand (PD-L1). Today, half of all patients with metastatic disease are eligible to receive immune checkpoint inhibitor (ICI) therapy. As of December 2021, there were eight approved agents available for 17 malignancies, and more than 1,000 clinical trials have been conducted to explore these agents in adjuvant and maintenance settings.
 The immune activation that underlies ICI therapy and the persistence of clinical response beyond the pharmacologic half-life also explain the toxicities that have been observed. Immune-related adverse events (irAEs) from ICI therapy have been shown to occur in virtually every organ system. They manifest at varying times during treatment, sometimes occurring after its discontinuation. Interestingly, the presence of these adverse events (AEs) is related to the immune system’s degree of self-tolerance and predicts patient response to this treatment modality.
 Endocrinopathies are some of the most common irAEs, occurring in 15–40% of patients; however, they have posed challenges for clinicians as they are difficult to diagnose due to diverse and non-specific manifestations. In contrast to other irAEs, endocrinopathies do not respond to high-dose glucocorticoids and they are permanent. Steroid treatment has been shown to have no effect on the disease severity or the likelihood of resolution. Fortunately, when diagnosed appropriately, ICI-associated endocrinopathies are easy to treat, do not necessitate treatment discontinuation, and have an excellent prognosis.

Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.

How this classification was reachedexpand

Full frame distilled prediction

Teacher imitation

Not calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.

metaresearch head score (Codex)0.000
metaresearch head score (Gemma)0.000
Version: codex-gemma-dda1882f352aValidation status: machine_predicted_unvalidated
Candidate categoriesMeta-epidemiology (narrow)
Consensus categoriesnone
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Observational · Consensus signal: Observational
GenreCandidate signal: Empirical · Consensus signal: Empirical
Teacher disagreement score0.077
Threshold uncertainty score1.000

Codex and Gemma teacher scores by category

CategoryCodexGemma
Metaresearch0.0000.000
Meta-epidemiology (narrow)0.0000.000
Meta-epidemiology (broad)0.0010.000
Bibliometrics0.0010.001
Science and technology studies0.0000.000
Scholarly communication0.0000.000
Open science0.0000.000
Research integrity0.0000.000
Insufficient payload (model declined to judge)0.0010.000

Machine scores (provisional)

The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.

Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.

Opus teacher head0.012
GPT teacher head0.230
Teacher spread0.217 · how far apart the two teachers sit on this one work
Validation statusscore_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it

Classification

machine, unvalidated

Machine predicted; a candidate call from one teacher head, not a consensus.

Study designObservational
Domainnot available
GenreEmpirical

How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".

Quick stats

Citations0
Published2023
Admission routes1
Has abstractyes

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