| Abstrakt: |
Simple Summary: Recently, a new type of cancer treatment called immune checkpoint inhibitors (ICIs) has become an option for many cancer patients, including children. While these treatments are effective against different types of cancer, they can lead to immune-related side effects impacting different organs. However, knowledge about the effect of ICIs on testicular function and male fertility is limited. There is a possibility that ICI treatment directly or indirectly affects testicular function and sperm production. This review looks at the available evidence on how ICIs, especially those targeting cytotoxic T-lymphocyte-associated protein 4 (CTLA-4), programmed death protein 1 (PD-1) and programmed death-ligand 1 (PD-L1), may disrupt sperm production. It also emphasizes the need for further investigations and encourages discussions about associated risks and fertility-preservation options between clinicians and patients. In recent years, immune checkpoint inhibitors (ICIs) have become a viable option for many cancer patients, including specific subgroups of pediatric patients. Despite their efficiency in treating different types of cancer, ICIs are responsible for a number of immune-related adverse events, including inflammatory toxicities, that can affect several organs. However, our knowledge of the impact of ICIs on the testis and male fertility is limited. It is possible that ICI treatment affects testicular function and spermatogenesis either directly or indirectly (or both). Treatment with ICIs may cause increased inflammation and immune cell infiltration within the seminiferous tubules of the testis, disturbing spermatogenesis or testosterone deficiency (primary hypogonadism). Additionally, the interference of ICIs with the hypothalamic–pituitary–gonadal axis may alter testosterone production, affecting testicular function (secondary hypogonadism) and spermatogenesis. This review provides an overview of the available evidence on the potential association between ICIs and the disruption of spermatogenesis, with special focus on ICIs targeting cytotoxic T-lymphocyte-associated protein 4 (CTLA-4), programmed death protein 1 (PD-1) and programmed death-ligand 1 (PD-L1). Moreover, it highlights the need for further investigations and encourages the discussion of associated risks and fertility-preservation considerations between clinicians and patients. [ABSTRACT FROM AUTHOR] |
