Immune checkpoint inhibitor (ICI) therapy can trigger hypophysitis as an immune-related adverse event. When this presents at grade 1 (asymptomatic) or grade 2 (mildly symptomatic), a specific, structured approach allows continued oncological treatment alongside endocrine management.
This protocol addresses patients who develop immune checkpoint inhibitor-induced hypophysitis (ICIHy) at grade 1 (asymptomatic) or grade 2 (mildly symptomatic) severity. The key clinical decision point at this grade involves balancing endocrine support with continuation of the underlying ICI regimen.
Management at this grade centres on hormone replacement to address pituitary hormone deficits. Importantly, the structured protocol addresses whether the immune checkpoint inhibitor therapy itself needs to be modified — a critical and nuanced decision at this grade of toxicity.
DOI: 10.1016/j.beem.2019.101371
For grade 1 (asymptomatic) or grade 2 (mildly symptomatic) ICIHy, hormone replacement can be provided and there is no need for discontinuation of ICI therapy.
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