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Experimental Melanoma Immunotherapy Model Using Tumor Vaccination with a Hematopoietic Cytokine
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Testosterone deficiency in men receiving immunotherapy for malignant melanoma
Madeline Peters1, Amy Pearlman2, William Terry3
1Carver College of Medicine, University of Iowa, Iowa City, IA, 52242, USA.
Oncotarget
|February 22, 2021
Summary
Many men undergoing immunotherapy for melanoma experience low testosterone, a condition often linked to fatigue. Despite this, few receive testosterone replacement therapy, highlighting a potential gap in care for these cancer patients.
Area of Science:
- Oncology
- Endocrinology
- Immunology
Background:
- Immunotherapy is a standard melanoma treatment.
- Emerging evidence suggests immunotherapy can cause endocrine dysfunction.
- Testosterone deficiency is a potential side effect impacting male patients.
Purpose of the Study:
- To determine the prevalence of low testosterone in men with malignant melanoma receiving immunotherapy.
- To assess the rate of testosterone replacement therapy (TRT) initiation following diagnosis of low testosterone.
- To identify symptoms associated with low testosterone in this patient cohort.
Main Methods:
- Retrospective chart review of patients with malignant melanoma treated with immunotherapy.
- Analysis of testosterone levels before, during, and after immunotherapy.
- Documentation of TRT and reported symptoms, including fatigue and hypophysitis.
Main Results:
- Low testosterone was identified in 34 out of 49 patients (69%) during immunotherapy.
- Only 3 patients received TRT despite documented low testosterone.
- Fatigue was reported by 43 out of 49 patients (88%).
- Four patients (8%) developed hypophysitis and hypopituitarism, all on Ipilimumab.
Conclusions:
- Patients with advanced melanoma (Stage 3 or 4) treated with immunotherapy face a significant risk of testosterone deficiency.
- There appears to be under-treatment of testosterone deficiency in this population.
- Hypophysitis is a notable risk, particularly with Ipilimumab treatment.
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