{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T18:17:44Z","timestamp":1783448264410,"version":"3.55.0"},"reference-count":11,"publisher":"Bioscientifica","license":[{"start":{"date-parts":[[2026,3,5]],"date-time":"2026-03-05T00:00:00Z","timestamp":1772668800000},"content-version":"vor","delay-in-days":2620,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["journals.bioscientifica.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2019,1,1]]},"abstract":"<jats:sec>\n                    <jats:title>Summary<\/jats:title>\n                    <jats:p>Programmed cell death protein 1\/programmed cell death protein ligand 1 (PD-1\/PD-L1) and cytotoxic T-lymphocyte antigen 4\/B7 (CTLA-4\/B7) pathways are key regulators in T-cell activation and tolerance. Nivolumab, pembrolizumab (PD-1 inhibitors), atezolizumab (PD-L1 inhibitor) and ipilimumab (CTLA-4 inhibitor) are monoclonal antibodies approved for treatment of several advanced cancers. Immune checkpoint inhibitors (ICIs)-related hypophysitis is described more frequently in patients treated with anti-CTLA-4; however, recent studies reported an increasing prevalence of anti-PD-1\/PD-L1-induced hypophysitis which also exhibits slightly different clinical features. We report our experience on hypophysitis induced by anti-PD-1\/anti-PD-L1 treatment. We present four cases, diagnosed in the past 12 months, of hypophysitis occurring in two patients receiving anti-PD-1, in one patient receiving anti-PD-1 and anti-CTLA-4 combined therapy and in one patient receiving anti-PD-L1. In this case series, timing, clinical presentation and association with other immune-related adverse events appeared to be extremely variable; central hypoadrenalism and hyponatremia were constantly detected although sellar magnetic resonance imaging did not reveal specific signs of pituitary inflammation. These differences highlight the complexity of ICI-related hypophysitis and the existence of different mechanisms of action leading to heterogeneity of clinical presentation in patients receiving immunotherapy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Learning points:<\/jats:title>\n                  <\/jats:sec>","DOI":"10.1530\/edm-19-0102","type":"journal-article","created":{"date-parts":[[2020,7,27]],"date-time":"2020-07-27T10:47:13Z","timestamp":1595846833000},"update-policy":"https:\/\/doi.org\/10.1530\/crossmarkpolicy-2","source":"Crossref","is-referenced-by-count":27,"title":["Clinical heterogeneity of hypophysitis secondary to PD-1\/PD-L1 blockade: insights from four cases"],"prefix":"10.1530","volume":"2019","author":[{"given":"Isabella","family":"Lupi","sequence":"first","affiliation":[{"name":"Endocrinology Unit 1","department":["Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessandro","family":"Brancatella","sequence":"additional","affiliation":[{"name":"Endocrinology Unit 1","department":["Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mirco","family":"Cosottini","sequence":"additional","affiliation":[{"name":"Neuroradiology 2","department":["Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicola","family":"Viola","sequence":"additional","affiliation":[{"name":"Endocrinology Unit 1","department":["Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giulia","family":"Lanzolla","sequence":"additional","affiliation":[{"name":"Endocrinology Unit 1","department":["Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniele","family":"Sgr\u00f2","sequence":"additional","affiliation":[{"name":"Endocrinology Unit 1","department":["Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giulia Di","family":"Dalmazi","sequence":"additional","affiliation":[{"name":"Section of Endocrinology 3","department":["Department of Medicine and Aging Sciences, Ce.S.I-Me.T., \u201cG.D\u2019Annunzio\u201d University of Chieti-Pescara, Chieti, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Latrofa","sequence":"additional","affiliation":[{"name":"Endocrinology Unit 1","department":["Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrizio","family":"Caturegli","sequence":"additional","affiliation":[{"name":"Division of Immunology 4","department":["Department of Pathology, Johns Hopkins University, Baltimore Maryland, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudio","family":"Marcocci","sequence":"additional","affiliation":[{"name":"Endocrinology Unit 1","department":["Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"416","published-online":{"date-parts":[[2019,10,12]]},"reference":[{"key":"2026070713480622900_bib1","first-page":"5269062","article-title":"Long-term survival, quality of life, and psychosocial outcomes in advanced melanoma patients treated with immune checkpoint inhibitors","author":"Rogiers","year":"2019","journal-title":"Journal of 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