Zusammenfassung
Bei Chemotherapien sind akute endokrine oder metabolische Nebenwirkungen selten. Langfristig erhöhen chemotherapiebedingte endokrine und metabolische Veränderungen das Risiko für kardiovaskuläre Erkrankungen sowie Infertilität. Bei zielgerichteten Therapien sind Störungen der Schilddrüsenfunktion häufig. Inhibitoren der PI3K-mTOR-Achse können die Insulinwirkung hemmen und damit zu Hyperglykämien führen. Im Gegensatz dazu führen viele andere Tyrosinkinase-Inhibitoren zu milden, meist nicht behandlungsbedürftigen Hypoglykämien. Endokrine Toxizitäten durch zielgerichtete Therapien sind in der Regel nach Absetzen der Behandlung reversibel. Immuntherapien mit Checkpoint-Inhibitoren führen besonders häufig zu endokrinologischen Nebenwirkungen. Am häufigsten sind auch hier Schilddrüsenfunktionsstörungen. Anti-CTLA4-Antikörper können Entzündungen der Hypophyse verursachen. Im Gegensatz zu den zielgerichteten Therapien sind endokrine Toxizitäten von Immuntherapien oft irreversibel.
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Wicki, A. (2020). Metabolische und endokrine Toxizität antineoplastischer Substanzen. In: Schmoll, HJ. (eds) Kompendium Internistische Onkologie . Springer Reference Medizin. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-46764-0_284-1
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