TABLE 3.
Detailed clinical profiles of patients with adrenal insufficiency
| Patient no. | Clinical findings | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| Age | Sex | Treatment | Line | Cycles | Time to event (months) | CTCAE (grade) | Symptoms | Laboratory findings | |
| 1 | 70 | F | Pembrolizumab | 2 | 7 | 4.7 | 3 | Fatigue, nausea, headache | Hyponatremia, hypoglycemia |
| 2 | 70 | M | Pembrolizumab | 1 | 8 | 10.0 | 3 | No symptoms | Hyponatremia |
| 3 | 49 | F | CBDCA + PEM + pembrolizumab | 2 | 14 | 15.4 | 4 | Loss of appetite, fever, arthralgia | Hyponatremia, eosinophilia |
| 4 | 52 | M | CBDCA + PEM + pembrolizumab | 1 | 7 | 11.2 | 3 | Fatigue, loss of appetite, weight loss | Eosinophilia |
| 5 | 80 | F | CBDCA + PEM + pembrolizumab | 1 | 8 | 7.3 | 3 | Fatigue | Hyponatremia |
| 6 | 82 | M | Pembrolizumab | 2 | 14 | 9.8 | 2 | Fatigue, loss of appetite, weight loss | Hyponatremia, eosinophilia |
| 7 | 75 | M | CBDCA + nab‐PTX + pembrolizumab | 1 | 4 | 3.8 | 3 | fatigue, fever, loss of appetite | Hyponatremia, eosinophilia |
| 8 | 60 | M | CBDCA + PEM + pembrolizumab | 1 | 6 | 5.2 | 3 | Loss of appetite, Disturbance of consciousness | Hyponatremia |
| 9 | 56 | M | Pembrolizumab | 5 | 13 | 8.9 | 3 | Fatigue | Hyponatremia |
| 10 | 67 | F | CBDCA + PEM + pembrolizumab | 6 | 7 | 7.0 | 3 | Loss of appetite, Convulsion | Hyponatremia, hypoglycemia |
| Patient no | Hormone level | Pattern of AI | |||||||
|---|---|---|---|---|---|---|---|---|---|
| Cortisol (μg/dl) | ACTH (pg/ml) | Secondary AI | IAD | Multiple hormone deficiencies | Brain imaging | Other irAE | Hormone replacement therapy (maintenance dose) | Re‐administration of pembrolizumab | |
| 1 | 5 | 12 | ○ | – | ACTH, Gn | No abnormality | Cholangitis, skin toxicity | Dexamethasone 0.5 mg | ○ |
| 2 | 2.4 | 10.1 | ○ | ○ | – | No abnormality | Pneumonitis, thyroid dysfunction, skin toxicity | Prednisolone 20 mg | ○ |
| 3 | 4.8 | ≦3.0 | ○ | ○ | – | No abnormality | Thyroid dysfunction | Hydrocortisone 15 mg | – |
| 4 | 0.6 | <1.5 | ○ | ○ | – | No abnormality | Pneumonitis | Hydrocortisone 15 mg | ○ |
| 5 | 0.6 | 4.2 | ○ | ○ | – | No abnormality | – | hydrocortisone 15 mg | ○ |
| 6 | 3.7 | 29 | ○ | Not tested | Not tested | Not tested | Skin toxicity | Hydrocortisone 5 mg | ○ |
| 7 | 1 | <1.5 | ○ | Not tested | Not tested | No abnormality | Skin toxicity | Hydrocortisone 15 mg | – |
| 8 | 1.5 | <1.5 | ○ | Not tested | Not tested | No abnormality | Thyroid dysfunction, colitis | Hydrocortisone 30 mg | – |
| 9 | 1.9 | 9.7 | ○ | Not tested | Not tested | Not tested | Skin toxicity | Hydrocortisone 20 mg | – |
| 10 | 1.4 | 1.5 | ○ | ○ | – | No abnormality | Skin toxicity | Hydrocortisone 15 mg | – |
Abbreviations: ACTH, adrenocorticotropic hormone; AI, adrenal insufficiency; CBDCA, carboplatin; CDDP, cisplatin; CTCAE, Common Terminology Criteria for Adverse Events version 4.0; F, female; Gn, gonadotropin; IAD, isolated adrenocorticotropic hormone deficiency; M, male; nab‐PTX, nab‐paclitaxel; PEM, pemetrexed.