Table 1.
Clinical features, biochemical results, radiological findings and management of patients within the study cohort
| Cancer disease group | ICI | Cycle | Presenting complaint | Blood pressure (mmHg) | Random blood glucose (mmol/L) | Sodium (mmol/L) (133–146) | Cortisol (nmol/L) | ACTH (ng/L) (5–46) | TSH (mU/L) (0.4–5.0) | Free T4 (pmol/L) (10–22) | MRI scan of the pituitary | Time to OPD endo review (days) |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Combination ICI therapy | ||||||||||||
| Melanoma | Ipi/Nivo | 1 | Headache | 150/80 | 7.9 | 138 | <50 | <5 | 0.13 | 9.0 | NAD | 6 |
| Headache/fatigue/postural dizziness | 110/70 | 6.9 | 132 | <50 | <5 | 0.05 | 10.8 | Patient did not tolerate MRI | 8 | |||
| Headache/fatigue | 110/70 | 3.7 | 131 | <50 | <5 | 9.01 | 14.1 | NAD | 8 | |||
| Fatigue/nausea/headache | 110/70 | 3.7 | 131 | <50 | <5 | 0.03 | 15.9 | Pituitary inflamed | 8 | |||
| Renal | Ipi/Nivo | 4 | Headache/fatigue | 120/70 | 6.8 | 134 | <50 | <5 | <0.02 | 14.4 | NAD | 7 |
| 3 | Headache/fatigue/blurred vision | 140/70 | 5.3 | 130 | <50 | <5 | <0.02 | 19.8 | Contra-indicated | 4 | ||
| Nivo; previously Ipi/Nivo | 8 | Fatigue/nausea/postural dizziness | 110/70 | 5.5 | 136 | <50 | 10 | 7.17 | 12.3 | NAD | 13 | |
| Single-agent PD-1 therapy | ||||||||||||
| Colorectal | Nivo | 6 | Headache/fatigue | 140/70 | 5.8 | 125 | <50 | <5 | 5.61 | 18.1 | NAD | 7 |
| Pem | 6 | Fatigue | 110/70 | 4.7 | 139 | <50 | <5 | 1.53 | 15.4 | Not done | 7 | |
| Gastric | Nivo | 4 | Fatigue | 140/75 | 4.7 | 133 | <50 | <5 | 35.79 | 5.5 | NAD | 9 |
| Melanoma | Pem | 2 | Headache/fatigue | 110/70 | 6 | 139 | <50 | <5 | 2.76 | 10.7 | NAD | 8 |
| Nivo | 4 | Headache/ fatigue/postural dizziness | 140/70 | 7.0 | 141 | <50 | <5 | 0.27 | 16.4 | Not tolerated | 7 | |
| NSCLC | Pem | 2 | Headache/fatigue | 100/60 | 4.9 | 129 | <50 | <5 | 7.72 | 15.3 | NAD | 13 |
| 13 | Fatigue/postural dizziness | 90/50 | 2.9 | 135 | <50 | 6 | 0.25 | 19.5 | NAD | 8 | ||
ACTH = adrenocorticotrophic hormone; BP = blood pressure; Endo = endocrinology; ICI = immune checkpoint inhibitor; Ipi = ipilimumab; MRI = magnetic resonance imaging; Nivo = nivolumab; NSCLC = non-small cell lung cancer; OPD = outpatient department; TSH = thyroid-stimulating hormone.