Literature case analysis of hypophysitis due to nivolumab
10.3760/cma.j.cn114015-20240701-00503
- VernacularTitle:纳武利尤单抗相关垂体炎文献病例分析
- Author:
Hengheng DAI
1
;
Weiwei KONG
Author Information
1. 江苏省盐城市第二人民医院药剂科，盐城 224003
- Publication Type:Journal Article
- Keywords:
Antineoplastic agents;
Immune checkpoint inhibitors;
Immune-related adverse events;
Hypophysitis;
Nivolumab
- From:
Adverse Drug Reactions Journal
2025;27(2):99-106
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To understand the clinical characteristics of hypophysitis due to nivolumab and provide reference for the safe use of nivolumab in clinic.Methods:Relevant databases at home and abroad (up to May 31, 2024) were searched and case reports of hypophysitis caused by nivolumab were collected. Relevant information of patients (gender, age, primary disease), single and combined use of nivolumab, occurrence of hypophysitis, causality evaluation, intervention measures and outcomes were extracted and analyzed descriptively and statistically.Results:A total of 56 case reports, 53 in English and 3 in Chinese, were enrolled in the analysis, involving 59 patients, with 40 males and 19 females. Their ages ranged from 26 to 84 years, with an average age of 61 years. The primary diseases were malignant melanoma in 20 cases, renal cell carcinoma in 19 cases, lung cancer in 11 cases, glossopharyngeal cancer in 4 cases, esophageal cancer in 2 cases, and gastric cancer, colon cancer and pleural mesothelioma in 1 case each. Among the 59 patients, 33 were treated with nivolumab monotherapy, 24 with nivolumab and ipilimumab, 1 with nivolumab and anlotinib and 1 with nivolumab and platinum. The average time of hypophysitis caused by nivolumab alone was 25.6 weeks after treatment, and that caused by the combination therapy was 9.9 weeks after treatment. The main clinical manifestations of hypophysitis caused by nivolumab were fatigue, anorexia, headache, and nausea. Among the 59 patients, 56 patients discontinued nivolumab and received glucocorticoid, 20 of whom resumed nivolumab treatment after improvement of clinical symptoms; 3 patients′ situation was not described clearly. The outcomes of the 59 patients were as follows. Four were recovered, 46 were relieved, 2 patients′ pituitary function was not recovered, 4 died, 1 developed secondary autoimmune vasculitis, 1 developed secondary autoimmune hepatitis, and it was unknown in one patient.Conclusions:The average occurrence time of hypophysitis caused by nivolumab monotherapy is longer than that caused by combination therapy. The main clinical manifestations are fatigue, anorexia, headache, etc. After timely discontinuation of medication and symptomatic treatments with glucocorticoid, most patients have a good prognosis, but it can lead to death in severe cases.
