The Rise of Oncoendocrinology: How Modern Cancer Therapies Are Reshaping Endocrine Practice
Nidha Shapoo, Noella Boma, Vladimir Gotlieb, Joseph Mattana, Regina Belokovskaya, Alberto FrancoThe emergence of immune checkpoint inhibitors, targeted therapies, CAR T-cell therapy, and antibody–drug conjugates has transformed modern oncology, significantly improving survival across a wide range of malignancies. However, these advances have also introduced a growing spectrum of endocrine and metabolic complications, redefining the scope of endocrine practice. Therapy-induced endocrinopathies, including thyroid dysfunction, hypophysitis, adrenal insufficiency, diabetes, pancreatitis, dyslipidemia, gonadal dysfunction, and metabolic syndrome, are recognized as clinically significant and often long-lasting consequences of cancer treatment. Unlike classical endocrine disorders, these conditions frequently present abruptly, display atypical clinical patterns, and require complex multidisciplinary management. This review explores the evolving field of oncoendocrinology, focusing on the mechanisms, clinical manifestations, and management of endocrine toxicities associated with novel cancer therapies. We also discuss the long-term endocrine sequelae of cancer treatment and the growing need for structured survivorship care and endocrine surveillance. In addition, we discuss future directions in oncoendocrinology, including predictive biomarkers, the need for treatment standardization, integrated care models, survivorship surveillance, and precision-based approaches to endocrine care. As cancer survival continues to improve, early recognition and long-term management of endocrine complications are becoming essential to optimizing both quality of life and overall outcomes in cancer survivors.