Early recognition of ipilimumab-related autoimmune hypophysitis in patients with metastatic melanoma: Case studies and recommendations for management

Asia Pac J Clin Oncol. 2015 Jun;11(2):190-4. doi: 10.1111/ajco.12348. Epub 2015 Apr 9.

Abstract

Ipilimumab is a human anti-CTLA-4 monoclonal antibody recently approved for the treatment of advanced melanoma. Stimulation of T-cell activity unmasks antitumor activity, but can cause immune-related adverse events. Autoimmune hypophysitis is of particular importance because its presentation can be subtle but life threatening. We present two cases where early recognition of ipilimumab-related autoimmune hypophysitis led to timely intervention and low subsequent morbidity, without compromise of antitumor effects. We provide recommendations for detection and management of this potentially life-threatening complication of ipilimumab.

Keywords: CTLA-4; autoimmune hypophysitis; ipilimumab; melanoma.

Publication types

  • Case Reports

MeSH terms

  • Antibodies, Monoclonal / adverse effects*
  • Autoimmune Hypophysitis / chemically induced*
  • Humans
  • Ipilimumab
  • Male
  • Melanoma / complications*
  • Melanoma / pathology
  • Middle Aged

Substances

  • Antibodies, Monoclonal
  • Ipilimumab