{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T03:34:25Z","timestamp":1790739265164,"version":"4.1.0"},"reference-count":54,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,8,18]],"date-time":"2025-08-18T00:00:00Z","timestamp":1755475200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Oncol."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Immune checkpoint inhibitors (ICIs) are effective against solid tumors but can trigger immune-related adverse events (irAEs), including adrenal insufficiency (AI). Given its impact on treatment efficacy and patient quality of life, understanding the clinical characteristics and outcomes of ICI-induced AI (ICI-AI) is critical.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We conducted a retrospective analysis of 46 patients diagnosed with ICI-AI at a single center (May 2019\u2013July 2024) and reviewed clinical trials\/real-world studies on ICI-AI.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The cohort included 22 cases of isolated adrenocorticotropic hormone deficiency (IAD), 23 of hypophysitis, and 1 of primary adrenal insufficiency (PAI). Median time to AI onset was 7.8 months (range: 1.5\u201327.4), with a median of 7 ICIs cycles (range: 1\u201321). Common symptoms were fatigue, anorexia, and nausea; comorbidities included hypothyroidism (41.3%) and hyponatremia (63%). No ACTH-deficient patients recovered during follow-up, but glucocorticoid replacement alleviated symptoms in most cases (45\/46). The objective remission rate for underlying malignancies post-AI was 63%. Concurrent irAEs in other organs were rare (3 cases).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The median time to AI onset and ICIs cycles administered are key indicators of AI development. Both IAD and hypophysitis are common secondary AI manifestations; glucocorticoid replacement enables safe ICIs continuation.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fonc.2025.1614223","type":"journal-article","created":{"date-parts":[[2025,8,18]],"date-time":"2025-08-18T04:10:28Z","timestamp":1755490228000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":4,"title":["Retrospective analysis of clinical characteristics and treatment of patients with immune checkpoint inhibitors-induced adrenal 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