Roula S. Zahr
BOSTON — Among adults with melanoma treated with the CTLA-4 immune checkpoint inhibitor ipilimumab, nearly 13% developed hypophysitis after therapy, according to data presented at the American Association of Clinical Endocrinologists annual meeting.
Although researchers were unable to identify reliable risk factors for the condition, “we found higher incidence of ipilimumab-induced hypophysitis in treatment-naive cancer patients,” Roula S. Zahr, MD, MS, assistant professor of medicine in the division of endocrinology, diabetes and clinical nutrition at the School of Medicine, Oregon Health and Science University, told Endocrine Today. “This finding has not been reported in previous studies.”
Zahr and colleagues at Oregon Health and Science University and University of Iowa Hospitals and Clinics performed a retrospective chart review of 117 patients with melanoma treated with ipilimumab (Yervoy, Bristol-Myers Squibb) from 2011 to 2016 to determine demographic and clinical characteristics of those who went on to develop the pituitary condition.
Among the cohort, 12.8% developed ipilimumab-induced hypophysitis, which the researchers described as “high,” with no differences between women and men. Men who developed hypophysitis were older than women who developed the condition (mean age, 67.7 years vs. 50.8 years; P = .009) and were older than men who did not develop the condition (mean age, 56.4 years; P = .02). Patients who received no systemic cancer therapy before ipilimumab were more likely to develop hypophysitis than those who had prior treatment (17.2% vs. none; P = .011). Researchers observed no associations with race, BMI, presence of baseline autoimmune diseases, lesion characteristics or genetic findings and likelihood of developing hypophysitis. Patients who developed hypophysitis had a median survival of 45 months vs. 29.5 months for those without the condition (P = .253).
“A screening protocol is needed to early identify and treat immune-related endocrine complications given the expanding use of cancer immunotherapy,” Zahr said.
The researchers recommend close monitoring for signs and symptoms of hypophysitis after each cycle of ipilimumab. – by Jill Rollet
Zahr R, et al. Abstract 838. Presented at: AACE Annual Scientific and Clinical Congress; May 16-20, 2018; Boston.
Disclosure: Zahr reports no relevant financial disclosures.