Abstract Specific human monoclonal antibodies antagonize cytotoxic T-lymphocyte antigen 4 (anti-CTLA-4 mAbs), a negative regulator of the immune system, inducing unrestrained T-cell activation. In patients with advanced or metastatic melanoma, one of these agents, ipilimumab, produced considerable disease control rates and, for the first time, a clear improvement in overall survival outcomes. However, accumulating clinical experience with anti-CTLA-4 mAbs identified a novel syndrome of autoimmune and autoinflammatory side effects, designated as "immune-related adverse events," including mainly rash, colitis, and hepatitis. Autoimmune hypophysitis has emerged as a distinctive side effect induced by anti-CTLA-4 mAbs. This condition may be life threatening because of adrenal insufficiency if not promptly recognized, but it may easily be diagnosed and treated if clinically suspected. Hypopituitarism caused by these agents is rarely reversible and prolonged or life-long substitutive hormonal treatment is often required. The precise mechanism of injury to the pituitary triggered by anti-CTLA-4 mAbs is yet to be fully elucidated.

Torino, F., Barnabei, A., DE VECCHIS, L., Salvatori, R., Corsello, S.m. (2012). Hypophysitis induced by monoclonal antibodies to cytotoxic T lymphocyte antigen 4: challenges from a new cause of a rare disease. THE ONCOLOGIST, 14(4), 525-535 [10.1634/theoncologist.2011-0404.].

Hypophysitis induced by monoclonal antibodies to cytotoxic T lymphocyte antigen 4: challenges from a new cause of a rare disease.

TORINO, FRANCESCO;DE VECCHIS, LIANA;
2012-01-01

Abstract

Abstract Specific human monoclonal antibodies antagonize cytotoxic T-lymphocyte antigen 4 (anti-CTLA-4 mAbs), a negative regulator of the immune system, inducing unrestrained T-cell activation. In patients with advanced or metastatic melanoma, one of these agents, ipilimumab, produced considerable disease control rates and, for the first time, a clear improvement in overall survival outcomes. However, accumulating clinical experience with anti-CTLA-4 mAbs identified a novel syndrome of autoimmune and autoinflammatory side effects, designated as "immune-related adverse events," including mainly rash, colitis, and hepatitis. Autoimmune hypophysitis has emerged as a distinctive side effect induced by anti-CTLA-4 mAbs. This condition may be life threatening because of adrenal insufficiency if not promptly recognized, but it may easily be diagnosed and treated if clinically suspected. Hypopituitarism caused by these agents is rarely reversible and prolonged or life-long substitutive hormonal treatment is often required. The precise mechanism of injury to the pituitary triggered by anti-CTLA-4 mAbs is yet to be fully elucidated.
2012
Pubblicato
Rilevanza internazionale
Articolo
Esperti anonimi
Settore MED/06 - ONCOLOGIA MEDICA
English
Con Impact Factor ISI
Anti-CTLA4 monoclonal antibodies; hypophysitis; melanoma
Torino, F., Barnabei, A., DE VECCHIS, L., Salvatori, R., Corsello, S.m. (2012). Hypophysitis induced by monoclonal antibodies to cytotoxic T lymphocyte antigen 4: challenges from a new cause of a rare disease. THE ONCOLOGIST, 14(4), 525-535 [10.1634/theoncologist.2011-0404.].
Torino, F; Barnabei, A; DE VECCHIS, L; Salvatori, R; Corsello, Sm
Articolo su rivista
File in questo prodotto:
File Dimensione Formato  
Torino et al. TheOncologist2012.pdf

accesso aperto

Dimensione 290.74 kB
Formato Adobe PDF
290.74 kB Adobe PDF Visualizza/Apri

I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/2108/77697
Citazioni
  • ???jsp.display-item.citation.pmc??? 22
  • Scopus 66
  • ???jsp.display-item.citation.isi??? 56
social impact