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Clinical characteristics of hypopituitarism induced by immune checkpoint inhibitors
Received:April 02, 2023  Revised:April 18, 2023  Click here to download the full text
Citation of this paper:ZHANG Lei,LI Xiao-mu,CHEN Hong.Clinical characteristics of hypopituitarism induced by immune checkpoint inhibitors[J].Chinese Journal of Clinical Medicine,2023,30(3):449-453
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Author NameAffiliationE-mail
ZHANG Lei Department of Endocrinology, Zhongshan Hospital, Fudan University, Shanghai 200032, China  
LI Xiao-mu Department of Endocrinology, Zhongshan Hospital, Fudan University, Shanghai 200032, China  
CHEN Hong Department of Endocrinology, Zhongshan Hospital, Fudan University, Shanghai 200032, China chen.hong1@zs-hospital.sh.cn 
Abstract:Objective To explore the clinical features of hypopitutarism induced by immune checkpoint inhibitors (ICIs) in patients with cancer. Methods A retrospective study was conducted to analyze the clinical manifestations, laboratory examination results and imaging characteristics of patients receiving ICIs who were admitted to the Department of Endocrinology, Zhongshan Hospital, Fudan University from January 2019 to June 2022. Results 23 patients were involved, including 13 males (53.5%) and 10 females (43.5%). The average age was (59.5±11.8) years. The ICIs included programmed cell death protein-1 (PD-1) monoantibody and cytotoxic T lymphocyte-associated antigen-4 (CTLA-4) monoantibody. Secondary adrenocortical insufficiency occurred in all cases, and diabetes insipidus was not seen. 3 patients (13.0%) had secondary hypothyroidism, 11 patients (47.8%) had normal thyroid function, and 9 patients (39.1%) had ICIs-related primary hypothyroidism. 4 patients (17.4%) had hypogonadism. Conclusions ICI-related hypopituitarism mainly manifests as secondary adrenocortical insufficiency, some involving in the hypothyroidism and hypogonadism, as well as thyroid gland damage. It is important to monitor functions of the pituitary and target glands of patients receiving ICIs.
keywords:immune checkpoint inhibitors  immune-related adverse events  hypopituitarism  adrenocortical insufficiency
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