在癌症治療的藥物發展史中，免疫檢查點抑制劑的發明堪稱具突破性的里程碑，自第一個該類藥物在2011 年被核准上市以來，其臨床應用為癌症病患帶來新的希望，也為兩位發明者帶來諾貝爾生醫獎的殊榮。然而，也因該類藥物作用於免疫系統之調節機制，在消滅癌細胞的同時，亦導致了自體免疫機制的抑制作用無法運作，因而導致數種內分泌器官功能異常之產生。最常發生的內分泌腺病症為腦下垂體炎。發炎反應可進一步造成中樞性腎上腺機能不全，此現象是極為嚴重的副作用，需要即刻給予糖皮質激素藥物的治療，以避免腎上腺危象的產生。藥物直接引起的甲狀腺發炎反應，因為甲狀腺細胞受到破壞及甲狀腺激素的大量釋放，在臨床上初期的表現大部分為類似亞急性甲狀腺炎的亢進症狀，隨後則轉變為甲狀腺低能症，需要甲狀腺素製劑的補充治療。當胰臟β 細胞受到免疫發炎影響時，可急速並大量受到破壞，導致胰島素分泌不足，血糖急速升高，甚至酮酸血症的發生，臨床表徵及實驗室數據皆指向胰島素依賴型糖尿病的診斷，一半以上的患者血液中可檢驗出抗胰島細胞的自體抗體，尤以anti-GAD65 為最常見；糖尿病一旦發生，絕大多數患者需要長期以胰島素療法控制血糖。隨著免疫檢查點抑制劑在癌症病患日漸廣泛的使用，內分泌功能異常之疾病亦隨之增加，臨床醫師應保持高度之臨床敏銳度，適時做出診斷與治療。

Immune checkpoint inhibitors (ICIs) are regarded as a break-through discovery and are used in regimens for treating patients with various malignancies, inducing activated T-cells to kill cancer cells; however, the safeguard autoimmune systems that are “checked and halted” in function before the use of ICIs, are re-activated after terminating the treatment. Thus, during the treatment course ICIs may stimulate and activate the development of various autoimmune disorders, mostly related to endocrine organs including the pituitary gland, thyroid gland, adrenal gland, and endocrine pancreas. The endocrine dysfunctions induced by ICI treatment include central adrenal insufficiency (AI) and central hypothyroidism related to hypophysitis of the adenohypophysis, primary hypothyroidism related to thyroiditis, and insulin-dependent diabetes mellitus (IDDM) caused by β-cell destruction in the endocrine pancreas. With the increasing use of ICIs, these immune-related adverse events have been observed as a prominent clinical entity that deserves clinical vigilance with respect to timely diagnosis and optimal treatment in addition to treating the underlying malignancies. These endocrine dysfunctions may not be readily diagnosed because of the insignificant clinical symptoms and signs presented. However, with such cases being increasingly recognized and reported, it would be prudent for physicians to regard these potential endocrine disorders as important in their daily practice when ICI-containing regimens are used. At any suspicion from vague clinical presentations, laboratory tests relevant to endocrine functions must be promptly performed to confirm a diagnosis. Treatment including measures of either replacement or suppression of disease characteristics should then be initiated and monitored regularly.