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Systemic High-Dose Corticosteroid Treatment Does Not Improve the Outcome of Ipilimumab-Related Hypophysitis: A Retrospective Cohort Study
Open accessAbstract
Purpose: To examine the onset and outcome of ipilimumab-related hypophysitis and the response to treatment with systemic high-dose corticosteroids (HDS). Experimental Design: Twenty-five patients who developed ipilimumab-related hypophysitis were analyzed for the incidence, time to onset, time to resolution, frequency of resolution, and the effect of systemic HDS on clinical outcome. To calculate the incidence, the total number (187) of patients with metastatic melanoma treated with ipilimumab at Dana-Farber Cancer Institute (DFCI; Boston, MA) was retrieved from the DFCI oncology database. Comparisons between corticosteroid treatment groups were performed using the Fisher exact test. The distributions of overall survival were based on the method of Kaplan–Meier. Results: The overall incidence of ipilimumab-related hypophysitis was 13%, with a higher rate in males (16.1%) than females (8.7%). The median time to onset of hypophysitis after initiation of ipilimumab treatment was 9 weeks (range, 5–36 weeks). Resolution of pituitary enlargement, secondary adrenal insufficiency, secondary hypothyroidism, male secondary hypogonadism, and hyponatremia occurred in 73%, 0%, 64%, 45%, and 92% of patients, respectively. Systemic HDS treatment did not improve the outcome of hypophysitis as measured by resolution frequency and time to resolution. One-year overall survival in the cohort of patients was 83%, and while it was slightly higher in patients who did not receive HDS, there was no statistically significant difference between treatment arms. Conclusion: Systemic HDS therapy in patients with ipilimumab-related hypophysitis may not be indicated. Instead, supportive treatment of hypophysitis-related hormone deficiencies with the corresponding hormone replacement should be given. Clin Cancer Res; 21(4); 749–55. ©2014 AACR.
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Improved Survival with Ipilimumab in Patients with Metastatic Melanoma
Hodi, F. S., O'Day, S. J., McDermott, D. F., Weber, R. W., Sosman, J. A., Haanen, J. B., Gonzalez, R., Robert, C., Schadendorf, D., Hassel, J. C., et al. (2010) · New England Journal of Medicine · doi:10.1056/nejmoa1003466 · Cited by 15,155
Self-citationSafety, activity, and immune correlates of anti–PD-1 antibody in cancer
Topalian, S. L., Hodi, F. S., Brahmer, J. R., Gettinger, S. N., Smith, D. C., McDermott, D. F., Powderly, J. D., Carvajal, R. D., Sosman, J. A., Atkins, M. B., et al. (2012) · New England Journal of Medicine · doi:10.1056/nejmoa1200690 · Cited by 12,628
Self-citationManagement of Immune-Related Adverse Events and Kinetics of Response With Ipilimumab
Weber, J. S., Kähler, K. C., & Hauschild, A. (2012) · Journal of Clinical Oncology · doi:10.1200/jco.2012.41.6750 · Cited by 1,415
Ipilimumab in patients with melanoma and brain metastases: an open-label, phase 2 trial
Margolin, K., Ernstoff, M. S., Hamid, O., Lawrence, D., McDermott, D., Puzanov, I., Wolchok, J. D., Clark, J. I., Sznol, M., Logan, T. F., et al. (2012) · The Lancet Oncology · doi:10.1016/s1470-2045(12)70090-6 · Cited by 1,091
Self-citationIwama, S., De Remigis, A., Callahan, M. K., Slovin, S. F., Wolchok, J. D., & Caturegli, P. (2014) · Science Translational Medicine · doi:10.1126/scitranslmed.3008002 · Cited by 715
Why glucocorticoid withdrawal may sometimes be as dangerous as the treatment itself
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Cancer immunotherapy—immune checkpoint blockade and associated endocrinopathies.
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Thompson, J. A., Schneider, B. J., Brahmer, J., Andrews, S., Armand, P., Bhatia, S., Budde, L. E., Costa, L., Davies, M., Dunnington, D., et al. (2019) · Journal of the National Comprehensive Cancer Network · doi:10.6004/jnccn.2019.0013 · Cited by 570
Faje, A. T., Lawrence, D., Flaherty, K., Freedman, C., Fadden, R., Rubin, K., Cohen, J., & Sullivan, R. J. (2018) · Cancer · doi:10.1002/cncr.31629 · Cited by 486
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Metadata
- Authors
- Min, L., Hodi, F. S., Giobbie-Hurder, A., Ott, P. A., Luke, J. J., Donahue, H., Davis, M., Carroll, R. S., & Kaiser, U. B.
- Venue
- Clinical Cancer Research
- Published
- 2015-02-15
- Volume
- 21
- Issue
- 4
- Pages
- 749-755
- ISSN
- 1078-0432 (ISSN-L)
- 1557-3265
- OpenAlex
- W1985110807
- Cited by
- 274
- References
- 6
- FWCI
- 7.18
- Type
- journal article
- Language
- en
- Open access
- green
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- Min, L., Hodi, F. S., Giobbie-Hurder, A., Ott, P. A., Luke, J. J., Donahue, H., Davis, M., Carroll, R. S., & Kaiser, U. B. (2015). Systemic High-Dose Corticosteroid Treatment Does Not Improve the Outcome of Ipilimumab-Related Hypophysitis: A Retrospective Cohort Study. Clinical Cancer Research. https://doi.org/10.1158/1078-0432.ccr-14-2353
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