Nivolumab induced hypophysitis in an advanced RCC patient

Abstract

Introduction

Immune checkpoint inhibitors (ICIs) are being commonly used to treat solid tumours such as renal cell carcinoma. Hypophysitis is an acute or chronic inflammation of the pituitary gland and nivolumab or pembrolizumab induced hypophysitis is markedly lower compared to ipilimumab.

Case report

We present a novel case of a patient with mRCC who was diagnosed with nivolumab induced hypophysitis based on clinical suspicion due to his hormonal profile and a range of symptoms that he developed during nivolumab immunotherapy.

Management and outcome

He was treated with high dose of hydrocortisone administered intravenously, subsequently changed to the oral route and physiologic dose.

Discussion

Nivolumab induced hypophysitis is a rare condition that usually presents with fewer symptoms. High degree of clinical suspicion and a multidisciplinary team required to diagnose and treat such cases.