Immune checkpoint blockade including programmed cell death 1 pathway inhibition with agents such as nivolumab is gaining ground in a wide array of malignancies, so far demonstrating significantly improved survival rates even in metastatic, often multiply pretreated settings.Although targeted in nature and generally well-tolerated compared with conventional anticancer treatments, these agents are often linked to a newly emerged group of adverse reactions, referred to as immune-related adverse events, which can also affect endocrine organs. This is a case report of a patient who received nivolumab for the treatment of recurrent metastatic non-small cell lung cancer and developed primary hypothyroidism and secondary adrenal insufficiency caused by selective pituitary dysfunction (with preservation of all other endocrine functions). After hormone replacement with daily administration of T4, T3 and hydrocortisone, the patient achieved complete recovery.Adequate characterisation of these rare yet potentially severe entities is essential for prompt diagnostic and therapeutic interventions that will permit us to fully benefit from these new agents’ therapeutic potential.

Background: The use of immune checkpoint inhibitors in upper track gastrointestinal malignancies is a major and rapidly evolving field of research. As a result in the last 5 years a lot of data have emerged from randomized clinical trials and even more are expected in the future. Methods:The aim of the study was to systematically review and examine in a pooled analysis all the data from randomized clinical studies on the use of immune checkpoint inhibitors compared to chemotherapy in the second line of treatment for advanced upper gastrointestinal cancers.