{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T06:10:01Z","timestamp":1777961401167,"version":"3.51.4"},"reference-count":22,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2020,5,24]],"date-time":"2020-05-24T00:00:00Z","timestamp":1590278400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2020,5,24]],"date-time":"2020-05-24T00:00:00Z","timestamp":1590278400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["J Endocrinol Invest"],"published-print":{"date-parts":[[2021,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Purpose<\/jats:title>\n                <jats:p>Ipilimumab, a monoclonal antibody inhibiting CLTA-4, is an established treatment in metastatic melanoma, either alone or in combination with nivolumab, and results in immune mediated adverse events, including endocrinopathy. Hypophysitis is one of the most common endocrine abnormalities. An early recognition of hypophysitis may prevent life threatening consequences of hypopituitarism; therefore, biomarkers to predict which patients will develop hypophysitis would have clinical utility. Recent studies suggested that a decline in TSH may serve as an early marker of IH. This study was aimed at assessing the utility of thyroid function tests in predicting development of hypophysitis.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>A retrospective cohort study was performed for all patients (<jats:italic>n<\/jats:italic>\u2009=\u2009308) treated with ipilimumab either as a monotherapy or in combination with nivolumab for advanced melanoma at the Royal Marsden Hospital from 2010 to 2016. Thyroid function tests, other pituitary function tests and Pituitary MRIs were used to identify those with hypophysitis.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results and conclusions<\/jats:title>\n                <jats:p>Ipilimumab-induced hypophysitis (IH) was diagnosed in 25 patients (8.15%). A decline in TSH was observed in hypophysitis cohort during the first three cycles but it did not reach statistical significance (<jats:italic>P<\/jats:italic>\u2009=\u20090.053). A significant fall in FT4 (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001), TSH index (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001) and standardised TSH index (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001) prior to cycles 3 and 4 in hypophysitis cohort was observed. TSH is not useful in predicting development of IH. FT4, TSH index and standardised TSH index may be valuable but a high index of clinical suspicion remains paramount in early detection of hypophysitis.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s40618-020-01297-3","type":"journal-article","created":{"date-parts":[[2020,5,24]],"date-time":"2020-05-24T17:02:14Z","timestamp":1590339734000},"page":"195-203","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["Predicting development of ipilimumab-induced hypophysitis: utility of T4 and TSH index but not TSH"],"prefix":"10.1007","volume":"44","author":[{"given":"M. S.","family":"Siddiqui","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Z. 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DLM has received speaker and advisory fees from BMS, MSD and Roche. JL has received Institutional research support from BMS, MSD, Novartis, Pfizer, Achilles Therapeutics, Roche, Nektar Therapeutics, Covance, Immunocore, Pharmacyclics, Aveo and Consultancy from Achilles, AZ, Boston Biomedical, BMS, Eisai, EUSA Pharma, GSK, Ipsen, Imugene, Incyte, iOnctura, Kymab, Merck Serono, MSD, Nektar, Novartis, Pierre Fabre, Pfizer, Roche\/Genentech, Secarna, Vitaccess and support from NIHR RM\/ICR Biomedical Research Centre for cancer. ST is funded by Cancer Research UK (grant reference number C50947\/A18176), the National Institute for Health Research (NIHR) Biomedical Research Centre at the Royal Marsden Hospital and Institute of Cancer Research (grant reference number A109), the Kidney and Melanoma Cancer Fund of The Royal Marsden Cancer Charity, The Rosetrees Trust (grant reference number A2204), and Ventana Medical Systems Inc (Grant reference numbers 10467 and 10530). ST has received speaking fees from Roche and Astra Zeneca. ST has the following patents filed: Indel mutations as a therapeutic target and predictive biomarker PCTGB2018\/051892 and PCTGB2018\/051893 and Clear Cell Renal Cell Carcinoma Biomarkers P113326GB.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interests"}},{"value":"All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and\/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}},{"value":"As all data was obtained as part of routine clinical care and collected retrospectively in an anonymised fashion consent was not required.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Informed consent"}}]}}