A Novel Etiology of Hypophysitis: Immune Checkpoint Inhibitors

Stuti Fernandes; Elena V. Varlamov; Shirley McCartney; Maria Fleseriu

doi:10.1016/j.ecl.2020.05.002

A Novel Etiology of Hypophysitis: Immune Checkpoint Inhibitors

Stuti Fernandes, Elena V. Varlamov, Shirley McCartney, Maria Fleseriu

Research output: Contribution to journal › Review article › peer-review

9 Scopus citations

Abstract

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.

Original language	English (US)
Pages (from-to)	387-399
Number of pages	13
Journal	Endocrinology and Metabolism Clinics of North America
Volume	49
Issue number	3
DOIs	https://doi.org/10.1016/j.ecl.2020.05.002
State	Published - Sep 2020

Keywords

Adrenal insufficiency
Cytotoxic T-lymphocyte-associated protein 4
Endocrine dysfunction
Hypophysitis
Immune checkpoint inhibitors
Immunotherapy
Programmed cell death
T lymphocytes

ASJC Scopus subject areas

Endocrinology, Diabetes and Metabolism
Endocrinology

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10.1016/j.ecl.2020.05.002

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title = "A Novel Etiology of Hypophysitis: Immune Checkpoint Inhibitors",

abstract = "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.",

keywords = "Adrenal insufficiency, Cytotoxic T-lymphocyte-associated protein 4, Endocrine dysfunction, Hypophysitis, Immune checkpoint inhibitors, Immunotherapy, Programmed cell death, T lymphocytes",

author = "Stuti Fernandes and Varlamov, {Elena V.} and Shirley McCartney and Maria Fleseriu",

note = "Publisher Copyright: {\textcopyright} 2020 Elsevier Inc.",

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doi = "10.1016/j.ecl.2020.05.002",

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volume = "49",

pages = "387--399",

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T2 - Immune Checkpoint Inhibitors

AU - Fernandes, Stuti

AU - Varlamov, Elena V.

AU - McCartney, Shirley

AU - Fleseriu, Maria

PY - 2020/9

Y1 - 2020/9

N2 - 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.

AB - 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.

KW - Adrenal insufficiency

KW - Cytotoxic T-lymphocyte-associated protein 4

KW - Endocrine dysfunction

KW - Hypophysitis

KW - Immune checkpoint inhibitors

KW - Immunotherapy

KW - Programmed cell death

KW - T lymphocytes

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JO - Endocrinology and Metabolism Clinics of North America

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ER -

A Novel Etiology of Hypophysitis: Immune Checkpoint Inhibitors

Abstract

Keywords

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