2014
DOI: 10.1007/s12020-014-0199-9
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Ipilimumab, not just another anti-cancer therapy: hypophysitis as side effect illustrated by four case-reports

Abstract: Ipilimumab is a monoclonal antibody that blocks cytotoxic T-lymphocyte antigen4 (CTLA-4), an inhibitory molecule typically expressed on T cells. Blockade of CTLA-4 induces an overall activation of T cells, including an immune-mediated anti-tumour response. Unfortunately, this broad T cell stimulation also causes immune-related adverse events (irAEs), such as dermatitis, colitis, hepatitis and hypophysitis. Ipilimumab is currently available in Belgium as a second line of treatment for patients with advanced mel… Show more

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Cited by 39 publications
(27 citation statements)
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“…With the replacement dose of hydrocortisone, the 7 th administration of nivolumab was successfully performed without deteriorations in the hormonal profile in our case (Table 3). Similar to the present case, the successful management of ipilimumabinduced hypophysitis with hydrocortisone replacement therapy has been reported [24]. A strategy for the treatment of idiopathic AH has recently been proposed that also emphasizes a conservative treatment [21].…”
Section: Discussionsupporting
confidence: 78%
“…With the replacement dose of hydrocortisone, the 7 th administration of nivolumab was successfully performed without deteriorations in the hormonal profile in our case (Table 3). Similar to the present case, the successful management of ipilimumabinduced hypophysitis with hydrocortisone replacement therapy has been reported [24]. A strategy for the treatment of idiopathic AH has recently been proposed that also emphasizes a conservative treatment [21].…”
Section: Discussionsupporting
confidence: 78%
“…The clinical manifestations of hypophysitis relate either to structural changes associated with the enlargement of the pituitary or to hormonal disturbance seen with autoimmune inflammation of the pituitary. Headache is usually reported as the initial symptom . Visual symptoms are rare and the measured change in pituitary size is reported on average as approximately 5 mm .…”
Section: Clinical Manifestations – Hypophysitismentioning
confidence: 99%
“…Concerning mild forms (grade 1) of immune checkpoint-related hypophysitis, continuation of immunotherapy and close observation are recommended [84] . For all other toxicity grades, it is recommended that ipilimumab be withheld and not resumed until the resolution of adverse events to grade 1 [83] .…”
Section: Treatmentmentioning
confidence: 99%