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The endocrine effects of these drugs include hypophysitis and thyroid dysfunction, with rare reports of adrenalitis. The overall incidence of hypophysitis with these medications is up to 9%. Primary thyroid dysfunction occurs in up to 15% of patients, with adrenalitis reported in approximately 1%. The mean onset of endocrine side effects is 9 weeks after initiation (range 5\u201336 weeks). Investigation and\/or screening for hypophysitis requires biochemical and radiological assessment. Hypopituitarism is treated with replacement doses of deficient hormones. Since the endocrine effects of immune checkpoint inhibitors are classed as toxic adverse events, most authors recommend both discontinuation of the immune checkpoint inhibiting medication and \u2018high\u2010dose\u2019 glucocorticoid treatment. However, this has been challenged by some authors, particularly if the endocrine effects can be managed (e.g. pituitary hormone deficiency), and the therapy is proving effective as an anticancer agent. This review describes the mechanism of action of immune checkpoint inhibitors and details the key clinical endocrine\u2010related consequences of this novel class of immunotherapies.<\/jats:p>","DOI":"10.1111\/cen.13063","type":"journal-article","created":{"date-parts":[[2016,3,22]],"date-time":"2016-03-22T02:30:09Z","timestamp":1458613809000},"page":"331-339","source":"Crossref","is-referenced-by-count":202,"title":["Immune checkpoint inhibitor\u2010related hypophysitis and endocrine dysfunction: clinical review"],"prefix":"10.1111","volume":"85","author":[{"given":"M.N","family":"Joshi","sequence":"first","affiliation":[{"name":"Departments of Endocrinology Guy's &amp; St Thomas NHS Foundation Trust London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"B.C.","family":"Whitelaw","sequence":"additional","affiliation":[{"name":"Department of Endocrinology Kings College London NHS Foundation Trust London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.T.P.","family":"Palomar","sequence":"additional","affiliation":[{"name":"Medical Oncology Guy's &amp; St Thomas NHS Foundation Trust London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Y.","family":"Wu","sequence":"additional","affiliation":[{"name":"Medical Oncology Guy's &amp; St Thomas NHS Foundation Trust London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P.V.","family":"Carroll","sequence":"additional","affiliation":[{"name":"Departments of Endocrinology Guy's &amp; St Thomas NHS Foundation Trust London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2016,4,13]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"publisher","DOI":"10.1126\/science.271.5256.1734"},{"key":"e_1_2_13_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.hoc.2014.02.002"},{"key":"e_1_2_13_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejca.2011.09.018"},{"key":"e_1_2_13_5_1","unstructured":"Pembrolizumab. 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