Searchable abstracts of presentations at key conferences in endocrinology
Endocrine Abstracts (2018) 56 S19.3 | DOI: 10.1530/endoabs.56.S19.3

ECE2018 Symposia New Aspects of Pituitary Regulation (3 abstracts)

How cancer treatment effects your pituitary

Frederique Albarel


France.


In recent years, immunotherapy has transformed the treatment in a number of cancers, including melanoma. It is associated with novel autoimmune side effects including endocrinopathies, among which hypophysitis (0.4–20% with Ipilimumab). We carried out a long-term study in endocrinology and dermatology departments of Marseille to characterise ipilimumab-induced hypophysitis in terms of clinical signs, endocrine profile and imaging, at diagnosis and during follow-up. Fifteen patients, treated for malignant melanoma and who presented ipilimumab-induced hypophysitis, were observed between June 2006 and August 2012 in our centre. Symptoms, pituitary function, and pituitary imaging at diagnosis of hypophysitis and during follow-up were recorded. Of 107 patients treated with ipilimumab, 15 (10 mg/kg in 11/15) presented with hypophysitis (14%) at 9.5±9 weeks (mean±S.D.) after treatment start, occurring in 66% after the third infusion. The main initial symptoms were headache (n=13) and asthenia (n=11). All patients but one had at least one hormonal defect: thyrotroph (n=13), gonadotroph (n=12), or corticotroph (n=11) deficiencies. None had diabetes insipidus. Pituitary imaging showed?a moderately enlarged gland in 12 patients. Clinical symptoms improved rapidly on high-dose glucocorticoids (n=11) or physiological replacement doses (n=4). At the end of follow-up (median 33.6 months, range 7–53.5), corticotroph deficiency remained in 13 patients, 11 recovered thyrotroph and 10 gonadotroph functions. Pituitary imaging remained abnormal in 11 patients. Ipilimumab-induced hypophysitis is a common side effect with frequent hormonal deficiencies at diagnosis. Usually, hormonal deficiencies improved, except for corticotroph function. Patients receiving these immunomodulatory therapies should be closely monitored especially by systematic baseline hormone measurements after the third infusion and remain? at risk of adrenal insufficiency in the long-term, needing education about adrenal failure risk. We will compare these results with other large international studies, discuss prognostic factors of hypophysitis due to immune check-point inhibitors, possible mechanisms and recommandations about follow-up and treatment.

Volume 56

20th European Congress of Endocrinology

Barcelona, Spain
19 May 2018 - 22 May 2018

European Society of Endocrinology 

Browse other volumes

Article tools

My recent searches

No recent searches.

My recently viewed abstracts

Authors