A Novel Etiology of Hypophysitis: Immune Checkpoint Inhibitors.

Endocrinol Metab Clin North Am

Department of Medicine (Endocrinology, Diabetes and Metabolism), Oregon Health & Science University, 3181 Southwest Sam Jackson Park Road, Mail Code L607, Portland, OR 97239, USA; Department of Neurological Surgery, Oregon Health & Science University, 3303 South Bond Avenue, Mail Code CH8N, Portland, OR 97239, USA; Pituitary Center, Oregon Health & Science University, 3303 South Bond Avenue, Mail Code CH8N, Portland, OR 97239, USA. Electronic address:

Published: September 2020

Checkpoint inhibitors trigger an immune process against cancer cells while causing cytotoxicity and self-antibody production against normal cells. Hypophysitis is a common endocrine toxicity. Hypophysitis may occur at any time during and after therapy, necessitating close clinical monitoring and screening for pituitary deficiencies. Treatment with high-dose glucocorticoids and temporary cessation of immunotherapy is indicated for severe hypophysitis with intractable headaches and vision changes, and for adrenal crisis. Increased awareness about this novel hypophysitis and multidisciplinary collaboration are needed to improve outcomes. This article reviews the function of immune checkpoint inhibitors and pituitary adverse effects with immune checkpoint inhibitor use.

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Source
http://dx.doi.org/10.1016/j.ecl.2020.05.002DOI Listing

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