Pituitary-adrenal dysfunction caused by nivolumab for head and neck cancer
| Autor: | Kosuke Hihara, Isaku Okamoto, Hiroki Sato, Hideki Tanaka, Ryo Maruyama, Ryota Tomioka, Yasuaki Katsube, Kiyoaki Tsukahara |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
Adrenal Cortex Diseases
Male Oncology medicine.medical_specialty Pituitary Diseases Pituitary-Adrenal System Adrenocorticotropic hormone 03 medical and health sciences Antineoplastic Agents Immunological 0302 clinical medicine Adrenocorticotropic Hormone Internal medicine medicine Humans 030223 otorhinolaryngology Hydrocortisone Hypopharyngeal Neoplasms Squamous Cell Carcinoma of Head and Neck business.industry Head and neck cancer Cancer Hypopharyngeal cancer Chemoradiotherapy General Medicine Middle Aged medicine.disease Otorhinolaryngologic Surgical Procedures Tongue Neoplasms Nivolumab Otorhinolaryngology 030220 oncology & carcinogenesis Surgery Neoplasm Recurrence Local business Blood sampling medicine.drug |
| Zdroj: | Auris Nasus Larynx. 46:896-901 |
| ISSN: | 0385-8146 |
| Popis: | Nivolumab exerts antitumor effects by inhibiting binding of PD-L1 to PD-1, and offers proven effectiveness in various disease areas, including cancers of the head and neck. The mechanisms of action lead nivolumab to induce immune-related adverse events (irAE). We report a case of pituitary-adrenal dysfunction to isolated adrenocorticotropic hormone (ACTH) deficiency as an irAE of nivolumab in a patient treated for head and neck cancer. This is the first report of an irAE of nivolumab in the field of head and neck squamous cell cancer. The patient was a man in his 50s with cancer of the tongue and hypopharynx that recurred after chemoradiotherapy, surgery and chemotherapy. After starting nivolumab, irAEs developed after 8 courses. The case was managed from the early stages in collaboration with the endocrinology department. Pituitary-adrenal hypofunction due to isolated ACTH deficiency was diagnosed on the basis of endocrine tests. The patient responded to hydrocortisone replacement therapy and has been able to continue treatment with nivolumab while continuing oral hydrocortisone. Although irAEs involving pituitary gland disorders are rare, these events can become life-threatening when severe. Early diagnosis and treatment are essential and require regular blood sampling and collaboration with specialists from an early stage. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Full Text from ScienceDirect