Cytotoxic T-lymphocyte-associated antigen-4 blockage can induce autoimmune hypophysitis in patients with metastatic melanoma and renal cancer

J Immunother. Nov-Dec 2005;28(6):593-8. doi: 10.1097/01.cji.0000178913.41256.06.

Abstract

Cytotoxic T-lymphocyte-associated antigen-4 (CTLA-4) is an immunoregulatory molecule expressed by activated T cells and resting CD4CD25 T cells. In patients with advanced melanoma, our group reported that administration of anti-CTLA-4 antibody mediated objective cancer regression in 13% of patients. This study also established that the blockade of CTLA-4 was associated with grade III/IV autoimmune manifestations that included dermatitis, enterocolitis, hepatitis, uveitis, and a single case of hypophysitis. Since this initial report, 7 additional patients with anti-CTLA-4 antibody-induced autoimmune hypophysitis have been accumulated. The characteristics, clinical course, laboratory values, radiographic findings, and treatment of these 8 patients are the focus of this report.

Publication types

  • Clinical Trial

MeSH terms

  • Adult
  • Antibodies, Monoclonal / administration & dosage
  • Antibodies, Monoclonal / adverse effects*
  • Antigens, CD
  • Antigens, Differentiation / immunology*
  • Autoimmune Diseases / blood
  • Autoimmune Diseases / chemically induced*
  • Autoimmune Diseases / pathology
  • Autoimmune Diseases / therapy
  • CTLA-4 Antigen
  • Carcinoma, Renal Cell / drug therapy
  • Carcinoma, Renal Cell / secondary
  • Humans
  • Kidney Neoplasms / drug therapy
  • Kidney Neoplasms / pathology
  • Magnetic Resonance Imaging
  • Male
  • Melanoma / drug therapy
  • Melanoma / secondary
  • Middle Aged
  • Neoplasm Metastasis
  • Pituitary Gland / drug effects*
  • Pituitary Gland / pathology
  • Skin Neoplasms / drug therapy
  • Skin Neoplasms / pathology

Substances

  • Antibodies, Monoclonal
  • Antigens, CD
  • Antigens, Differentiation
  • CTLA-4 Antigen
  • CTLA4 protein, human