Patterns of hormonal changes in hypophysitis by immune checkpoint inhibitor

Area of Science:

• Endocrinology
• Oncology
• Immunology

Background:

• Immune checkpoint inhibitors (ICIs) are associated with immune-related adverse events, including endocrine dysfunctions.
• Immune-related hypophysitis (irH) is a significant concern, but its clinical course and characteristics require further elucidation.

Purpose of the Study:

• To analyze the clinical course and characteristics of immune-related hypophysitis (irH) in patients treated with immune checkpoint inhibitors (ICIs).

Main Methods:

• A retrospective single-center study analyzed electronic medical records of adult patients with solid tumors treated with ICIs from January 2017 to June 2021.
• Evaluated thyroid, adrenal, gonadotropin, and growth hormone function, comparing patients with and without irH.

Main Results:

• Twenty-one patients were included; 13 had irH. No significant difference in clinical characteristics was observed between groups.
• The irH group showed high deficiency rates: 76.9% for ACTH, 61.5% for gonadotropins, 23.1% for TSH, and 15.4% for GH.
• The overall incidence of irH was 0.9 per person-year, with a median onset of 7.7 months post-ICI initiation.

Conclusions:

• Findings suggest that clinical course and characteristics may aid in predicting ICI-induced irH.
• Early identification and management of irH are crucial for patient health and quality of life.