To systematically summarize the clinical characteristics, therapeutic approaches, and prognostic outcomes of ipilimumab-induced hypophysitis.
Approach:
Study Design: Retrospective, case-based synthesis of published reports on ipilimumab-induced hypophysitis.
Search Strategy: Systematic search of PubMed, EMBASE, Web of Science, WanFang Data, and CNKI from inception to February 1, 2026.
Inclusion Criteria: Case reports or case series describing patients who developed hypophysitis during or following ipilimumab treatment.
Key Findings:
76 patients included; median age 58 years, 61.8% male.
Median time to onset of hypophysitis was 9 weeks, with over half occurring within the first 10 weeks.
Common symptoms included headache (68.0%) and fatigue (64.0%).
Secondary adrenal insufficiency was predominant, with low cortisol and ACTH levels in 93.4% and 89.8% of patients, respectively.
Pituitary enlargement was observed in 71.0% of patients undergoing MRI.
Glucocorticoid replacement was the primary treatment, with clinical improvement in 82.9% of patients.
Complete hormonal recovery was rare (7.9%).
80.3% of cases classified as probable according to the WHO–UMC system.
Interpretation:
Ipilimumab-induced hypophysitis typically occurs early in treatment and is characterized by secondary adrenal insufficiency and frequent pituitary enlargement.
Limitations:
Retrospective nature may limit the comprehensiveness of data.
Variability in reporting and assessment of cases.
Conclusion:
Long-term endocrine monitoring is warranted due to the common occurrence of persistent endocrine dysfunction.
