Table 1.

Evaluation of patients on ICIs immunotherapy for possible endocrinopathies

Baseline	•Clinical evaluation for symptoms: Extreme weakness, unusual headache patterns, vision changes, increased sweating, rapid heartbeat, weight loss or weight gain, mood changes, constipation or diarrhea, deepening of the voice, changes in urination, polydipsia, extreme or low hunger, nausea or vomiting, abdominal pain •Laboratory evaluation: Morning TSH, FT4, cortisol, glucose, electrolytes
Every 4-6 weeks and 4-6 weeks after the last cycle	•Clinical evaluation for symptoms •Laboratory evaluation: Morning TSH, FT4, cortisol, glucose, electrolytes
Additional tests
If hypothyroidism suspected	•Anti-TPO, anti-TG
If hyperthyroidism suspected	•T3 •TSH, FT4, T3 every 2-3 weeks to diagnose persistent hyperthyroidism or hypothyroidism (due to destructive thyroiditis) •TRAb (TSI)
If cortisol low	•ACTH •Consider ACTH stimulation test (250 μg i.v.) •Adrenal CT, if primary adrenal insufficiency
If hypophysitis suspected	•ACTH, LH, FSH, testosterone (men) or E2 (women) •PRL, IGF-1 can be also measured •Pituitary MRI, if multiple endocrine abnormalities, headaches or visual defects •DI is rare, but monitoring is important in some cases
If hyperglycemia	•pH, urine ketones •Autoantibodies (GADA, IA2, IAA, anti-ZnT8) •C peptide

ACTH, adrenocorticotropic hormone; CT, computed tomography; DI, diabetes insipidus; E2, estradiol; FSH, follicle stimulating hormone; FT4, free thyroxine; GADA, glutamic acid decarboxylase autoantibodies; IA2, islet autoantibodies; IAA, insulin autoantibodies; ICI, immune checkpoint inhibitors; IGF-1, insulin-like growth factor 1; LH, luteinizing hormone; MRI, magnetic resonance imaging; PRL, prolactin; T3, triiodothyronine; TG, thyroglobulin; TPO, thyroid peroxidase; TRAb, TSH receptor antibodies; TSH, thyroid stimulating hormone; TSI, thyroid stimulating immunoglobulin; ZnT8, zinc transporter.