Hypophysitis Associated with Immune Checkpoint Inhibitors

Area of Science:

• Endocrinology
• Oncology
• Immunology

Background:

• Immune checkpoint inhibitors (ICIs) are crucial in cancer therapy.
• ICIs can trigger immune-related adverse events (irAEs).
• ICI-related hypophysitis (IRH) is a significant endocrine irAE, often linked to anti-CTLA-4 therapy.

Purpose of the Study:

• To describe the clinical presentation and management of ICI-related hypophysitis.
• To highlight the diagnostic challenges and treatment strategies for IRH.

Main Methods:

• Clinical diagnosis based on patient presentation.
• Assessment of pituitary hormone function.
• Hormone replacement therapy.

Main Results:

• IRH commonly presents as central adrenal insufficiency.
• Other pituitary hormone deficits may coexist.
• Diagnosis relies on clinical evaluation due to lack of specific markers.

Conclusions:

• ICI-related hypophysitis requires clinical diagnosis.
• Management involves hormone replacement therapy.
• Discontinuation of immunotherapy and high-dose glucocorticoids are typically unnecessary.