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Tumor Immunotherapy

Tumor Immunotherapy

Immunotherapy is a treatment that boosts or manipulates the immune system to fight diseases, including cancer. For instance, by stimulating an immune response through vaccinations against viruses that cause cancers, like hepatitis B virus and human papillomavirus, these diseases can be prevented. Nonetheless, some cancer cells can avoid the immune system due to their rapid mutation and division. The immune response to many cancers involves three phases: elimination, equilibrium, and escape.

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Immunotherapy-Associated Hypophysitis under Anti-PD1: Two Case Reports.

Xinyu Shen¹, Minglan Yang¹, Hua Xu¹

¹Department of Endocrinology and Metabolic Diseases, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.

Endocrine, Metabolic & Immune Disorders Drug Targets

|December 12, 2022

Summary

This summary is machine-generated.

Immunotherapy can cause hypophysitis, a rare but serious condition. Regular endocrine monitoring is crucial for patients undergoing cancer immunotherapy to manage this adverse event effectively.

Keywords:

PD-1 Pituitary-irAE hormone replacement therapy immune checkpoint inhibitors immunotherapy immunotherapy-associated hypophysitis

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Area of Science:

Oncology
Endocrinology
Immunology

Background:

Immunotherapy, particularly with immune checkpoint inhibitors like PD-1 antagonists, can lead to hypophysitis, a rare but potentially severe adverse event.
Hypophysitis, inflammation of the pituitary gland, can result in hormonal deficiencies and significant clinical sequelae if not promptly managed.

Observation:

Two cases of immunotherapy-associated hypophysitis are presented: a 66-year-old man with non-small cell lung cancer treated with sintilimab and a 58-year-old patient with gastric cancer treated with carrelizumab.
Both patients experienced hormonal deficiencies (adrenal insufficiency) secondary to hypophysitis, necessitating hormone replacement therapy.

Findings:

Diagnosis involved assessing hyponatremia, low adrenocorticotropin and cortisol levels, and pituitary inflammation.
Treatment included physiological glucocorticoid replacement and continued immunotherapy, alongside hormone replacement therapy.

Implications:

Patients receiving cancer immunotherapy require regular endocrine-related follow-up to detect and manage hypophysitis.
Early detection and management of immunotherapy-associated hypophysitis are essential to prevent potentially fatal complications and allow for continued cancer treatment.