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Immunotherapy and hypophysitis: clinical presentation, treatment, and biologic insights
Abstract
Introduction Advances in immunotherapy have transformed the management of metastatic melanoma and generated encouraging results in the treatment of other malignancies. Autoimmune side effects from these agents, termed immune-related adverse events (IRAEs), are diverse and can include multiple endocrinopathies. Ipilimumab-induced hypophysitis (IH) is a recently recognized endocrine IRAE.Methods This review summarizes published data and experience from our center on the incidence, presentation and management, and proposed mechanisms for immunotherapy-related hypophysitis, with a focus on patients treated with ipilimumab (Ipi).Conclusion Hypophysitis occurs in a significant minority of patients treated with Ipi, in contrast to the relative rarity of idiopathic autoimmune hypophysitis or hypophysitis after treatment with other immunotherapies. Recently published cohorts have described the clinical presentation and management of IH and longitudinal outcomes in these patients. Additional studies with Ipi and other emerging agents have helped identify potential risk factors for the development of immunotherapy-related hypophysitis and possible underlying mechanisms for IH. Clarification of the mechanism(s) for IH may enhance our understanding of idiopathic autoimmune hypophysitis and could have potential therapeutic applications.
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“This is of significant clinical importance as the recently developed anti-CTLA4 (cytotoxic T lymphocyte protein 4) antibody treatments may result in the occurrence of hypophysitis in up to 10% of treated patients (Lam et al., 2015) with central hypothyroidism being the most frequently reported deficiency in the early phase (Faje, 2015).”
From The hypothalamus-pituitary-thyroid (HPT)-axis and its role in physiology and pathophysiology of other hypothalamus-pituitary functions (2021) · cites this paper as Faje, 2015
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Metadata
- Authors
- Faje, A.
- Affiliations
- Harvard University (US)
- Corresponding author
- Faje, Alexander
- ORCID
- Faje, Alexander
- Venue
- Pituitary
- Published
- 2015-07-18
- Volume
- 19
- Issue
- 1
- Pages
- 82-92
- ISSN
- 1386-341X (ISSN-L)
- 1573-7403
- OpenAlex
- W1185432402
- Cited by
- 326
- References
- 88
- Citations by year
- 2026: 12 · 2025: 25 · 2024: 16 · 2023: 29 · 2022: 32 · 2021: 37 · 2020: 49 · 2019: 36 · 2018: 41 · 2017: 31 · 2016: 18
- FWCI
- 3.22
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- www.springer.com/tdm (tdm)
- Locations
- Pituitary (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Oncology › Cancer Immunotherapy and Biomarkers
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Pituitary Gland Disorders and Treatments
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Adrenal Hormones and Disorders
- Keywords
- immune-related adverse events, immunotherapy, autoimmune hypophysitis, metastatic melanoma, endocrine adverse events, risk factors
- MeSH terms
- Hypophysitis, Ipilimumab, Antibodies, Monoclonal, Humans, Immunotherapy, CTLA-4 Antigen
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