Table 2 Cases of immune checkpoint inhibitors-induced hypophysitis and anterior pituitary insufficiency
Variable | Information |
|---|---|
1. Number of Reports | 84 |
2. Cases | 222 |
3. Gender | Males = 145; Females = 62; Not reported = 15 |
4. Age (years) | Median = 61; Mean + SD = 60.4 + 11.4; Range = 31–85 |
5. Pertinent medical history | PHxEndoD: Reported = 12; Not reported = 210 FHxEndoD: Reported = 2; Not reported = 220 PHxAutoD: Reported = 4; Not reported = 218 |
6. Type of cancer | Melanoma = 193; Renal cell carcinoma = 6; Prostate carcinoma = 7; non-small cell lung cancer = 5, lung cancer = 5; papillary thyroid carcinoma =1; mesothelioma =1; not reported = 4 |
7. Check point inhibitor ICI Drug D/C?: | Ipilimumab = 188; Nivolumab = 13; Tremelilumab = 4; CTLA-4 = 8; Atezolizumab = 2; Ipilimumab + Nivolumab = 3; Nivolumab, then Ipilimumab = 1; Ipilimumab, then Pembrolizumab = 2; Ipilimumab, then Nivomumab = 1. Yes = 45 No = 17 Not reported = 160 |
8. Clinical presentation | Reflects the hormone(s) affected |
9. Onset (weeks) after first dose | Median = 12; Mean = 13.8 + 10.3; Range 3–76 |
10. Biochemical tests | ↓ACTH/cortisol = 183; ↓TSH/FT4/FT3 = 172; ↓LH/FSH/T/Estradiol = 137; ↓PRL = 22; ↓GH/IGF-1 = 22. ↑TSH, ↓FT4,/FT3 = 2 |
11. Diagnosis (patients with # hormone deficiencies[def]) | 5 deficiency (def) = 7; 4 def = 14; 3 def = 72; 2 def = 47; One (isolated) def = 36 (31 ACTH, 4 TSH, 1 LH, FSH def). 3 reports with case series account for remainder |
12. Imaging Brain/Pituitary MRI/CT | Enlarged/Enhanced = 108; Normal 49; Not reported =11; Not done = 11; Sella abnormality = 3; atrophy = 3 3 reports with case series account for remainder |
13. CTCAE grade reported | Yes = 5; Not reported in 217 |
14. Therapy at onset at diagnosis | High dose steroids = 144; steroids = 62; no steroids = 7; Not reported = 9 |
15. Outcome | 219 recovered/discharged (replacement therapy 195 & 24 not reported); 3 deceased. |