ArticleThoracic cancer2023
Clinical characteristics of adrenal insufficiency induced by pembrolizumab in non-small-cell lung cancer.
Article in Thoracic cancer, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 1 of them a synthesis that pooled it.
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Who cites it
9 citing papers in PubMed, 1 synthesis or guideline pooled it, 15 citations in OpenAlex.
- Hyponatremia in cancer patients receiving immune checkpoint inhibitors: the ARON-MOUSEION-014 meta-analysis.Cancer metastasis reviews · 2026Pooled it
- Associations between Immune-related Adverse Events and Prognosis in Cancer Patients Receiving Immune Checkpoint Inhibitor Therapy.Internal medicine (Tokyo, Japan) · 2026Review
- Article
- A real-world drug safety surveillance study from the FAERS database of hepatocellular carcinoma patients receiving pembrolizumab alone and plus lenvatinib.Scientific reports · 2025Article
- Clinical outcomes of endocrine and other disorders induced by immune checkpoint inhibitors in Japanese patients.Scientific reports · 2025Observational
- PD-1/PD-L1 inhibitor-induced hyponatremia: a real-world pharmacovigilance analysis using FAERS database.Frontiers in immunology · 2025Article
- Article
- Pembrolizumab-Induced Adrenal Insufficiency Presenting Eight Months After Cessation of Treatment.Cureus · 2023Article
- Clinical characteristics of adrenal insufficiency induced by pembrolizumab in non-small-cell lung cancer.Thoracic cancer · 2023Article
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12 authors at 1 institution in 1 country.
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No grant is acknowledged in the PubMed record.
Abstract
BACKGROUND AND
aimImmune checkpoint inhibitors have significantly improved the clinical outcomes of many cancer types, but they induce a range of immune-related adverse events (irAEs). Although adrenal insufficiency (AI) is a rare irAE, it can lead to serious consequences. This study aimed to determine the clinical features of patients with advanced non-small-cell lung cancer (NSCLC) who developed AI following pembrolizumab treatment.
methodsWe retrospectively reviewed and analyzed the clinical data of all patients with NSCLC treated with pembrolizumab at Juntendo University Hospital from February 2017 to December 2020. The diagnosis of AI was established based on the Endocrine Emergency Guidance for the acute management of endocrine complications of checkpoint inhibitor therapy in the UK and the clinical practice guidelines of the Japan Endocrine Society.
resultAI was clinically suspected in 59 out of 186 patients treated with pembrolizumab, and 10 (5.4%) cases were confirmed. The symptoms included hyponatremia (n = 9), fatigue (n = 8), and loss of appetite (n = 6). All patients had low adrenocorticotropic hormone (ACTH) levels, and five patients were diagnosed with isolated ACTH deficiency. All patients completely recovered with corticosteroid replacement. The median time to onset of AI was 8.0 (range 3.8-15.2) months. The median progression-free survival in these patients was 22.4 (95% confidence interval 11.2-not reached) months.
conclusionThe incidence of AI among patients treated with pembrolizumab is more frequent than previously reported. In addition, secondary AI, especially isolated ACTH deficiency, is a major form of AI induced by pembrolizumab.
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