SynthesisPituitary2021
Isolated ACTH deficiency induced by cancer immunotherapy: a systematic review.
Synthesis in Pituitary, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 47 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
47 citing papers in PubMed, 2 syntheses or guidelines pooled it, 83 citations in OpenAlex.
- Hyponatremia in cancer patients receiving immune checkpoint inhibitors: the ARON-MOUSEION-014 meta-analysis.Cancer metastasis reviews · 2026Pooled it
- Immune checkpoint inhibitor-induced isolated adrenocorticotropic hormone deficiency: a systematic review.Frontiers in endocrinology · 2024Pooled it
- Immune-Mediated Hypophysitis: An Updated Review.Journal of clinical medicine · 2026Review
- Clinical characteristics and management of PD-1/PD-L1 inhibitor-induced secondary adrenal insufficiency.Endocrine connections · 2026Article
- Article
- Transient adrenocorticotropic hormone elevation with a disproportionate cortisol response prior to the onset of immune checkpoint inhibitor-related hypophysitis.Hormones (Athens, Greece) · 2026Review
- Isolated Adrenocorticotropin Deficiency With Depressive Symptoms.JCEM case reports · 2026Article
- Review
- Endocrinology and the Lung: Exploring the Bidirectional Axis and Future Directions.Journal of clinical medicine · 2025Article
- The Pituitary Immune Environment and Immunotherapy: From Hypophysitis to Pituitary Neuroendocrine Tumors.Cells · 2025Review
- Clinical characteristics and comparative analysis of PD-1/PD-L1 inhibitor-induced pituitary dysfunction versus other pituitary disorders.Scientific reports · 2025Article
- Management, biomarkers and prognosis in people developing endocrinopathies associated with immune checkpoint inhibitors.Nature reviews. Endocrinology · 2025Review
- Best practices in the management of thyroid dysfunction induced by immune checkpoint inhibitors.European thyroid journal · 2025Review
- Isolated adrenocorticotrophic hormone (ACTH) deficiency presenting with recurrent hypoglycemia and hyponatremia.Annals of medicine and surgery (2012) · 2025Article
- Immunotherapy-Related Hypophysitis: A Narrative Review.Cancers · 2025Review
- PD-1/PD-L1 inhibitor-induced hyponatremia: a real-world pharmacovigilance analysis using FAERS database.Frontiers in immunology · 2025Article
- Encephalitis and Immune-Related Complications in a Patient Treated With Nivolumab: A Case Report.Case reports in medicine · 2025Article
- Retrospective analysis of clinical characteristics and treatment of patients with immune checkpoint inhibitors-induced adrenal insufficiency.Frontiers in oncology · 2025Article
- Pembrolizumab-induced Thyroiditis, Hypophysitis and Adrenalitis: A Case of Triple Endocrine Dysfunction.JCEM case reports · 2024Article
- An Update on Advances in Hypopituitarism: Etiology, Diagnosis, and Current Management.Journal of clinical medicine · 2024Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Immunotherapy with immune checkpoint inhibitor (ICI) monoclonal antibodies has shown to be an effective therapeutic alternative in several malignant tumors. However, adverse effects related to an activation of the immune system may accompany ICI therapy. Among the immune-related adverse events (irAEs) are autoimmune endocrine adverse effects, such as thyroiditis, and hypophysitis. Secondary adrenal insufficiency due to isolated ACTH deficiency (IAD) has also been recently reported to be associated with ICI antibodies. We carried out a systematic review of IAD cases induced by cancer immunotherapy published to date using PubMed's database. We selected 35 articles that reported 60 cancer patients diagnosed with IAD induced by ICI therapy. The prevalence was higher in men (ratio 1.6/1). Mean age at diagnosis was 63.2 ± 11.6 (range,30-87). Melanoma was the tumor most commonly reported (35%) followed by lung (28.3%) and kidney cancer (18.3%). The ICI monoclonal antibody most frequently associated was nivolumab in monotherapy (60%), followed by pembrolizumab (18.3%). Median (IQR) time to develop IAD after starting ICI therapy was 6 (4-8) months. The main symptoms at IAD diagnosis were fatigue (82.8%) and anorexia (67.2%). Hyponatremia (68%) and eosinophilia (31.8%) were the laboratory abnormalities most frequently associated with IAD. Pituitary magnetic resonance imaging (MRI) was normal in most patients (93%). Thyroiditis was the most prevalent (35%) endocrine irAE associated with IAD. In conclusion, ICI-induced IAD is a rare and potentially life-threatening condition that must be taken into account whenever treatment with immunotherapy in cancer patients is started due to their potential serious prognostic implications.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.