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Ipilimumab-induced hypophysitis, a single academic center experience.

Travis Snyders1, Daniel Chakos2, Umang Swami3

  • 1Department of Internal Medicine, University of Iowa Hospitals and Clinics, Iowa City, IA, USA. travis-snyders@uiowa.edu.

Pituitary
|July 22, 2019
PubMed
Summary

Ipilimumab-induced hypophysitis (IH) occurred in nearly 13% of melanoma patients, with older men and those without prior cancer therapy at higher risk. IH did not impact progression-free or overall survival, highlighting the need for vigilant monitoring.

Keywords:
HypophysitisImmune related adverse side effectsImmunotherapyIpilimumabMalignant melanoma

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Area of Science:

  • Oncology
  • Immunology
  • Endocrinology

Background:

  • Immune checkpoint inhibitors like ipilimumab are crucial in cancer therapy.
  • Ipilimumab-induced hypophysitis (IH) is a known side effect with variable reported incidence.
  • Predictive factors and impact of IH on patient outcomes remain unclear.

Purpose of the Study:

  • To investigate the incidence of IH in melanoma patients treated with ipilimumab.
  • To identify clinical factors associated with the development of IH.
  • To evaluate the impact of IH on progression-free survival (PFS) and overall survival (OS).

Main Methods:

  • Retrospective review of 117 melanoma patients treated with ipilimumab (2011-2016).
  • Patients were categorized into groups with and without IH.
  • Analysis included demographic, clinical characteristics, treatment details, PFS, and OS.

Main Results:

  • 12.8% of patients developed IH; they were older males and had not received prior cancer therapy.
  • Older age was a significant factor for IH in males (P=0.020).
  • No significant differences in PFS (P=0.062) or OS (P=0.307) were observed between IH and non-IH groups.

Conclusions:

  • The incidence of IH in melanoma patients treated with ipilimumab is substantial (nearly 13%).
  • Older male patients and those without prior systemic therapy face a higher risk of IH.
  • Close monitoring for IH is essential due to the lack of clear predictive factors and its potential impact on treatment management.