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Onco Targets Ther. 2019 Mar 25;12:2181-2186. doi: 10.2147/OTT.S194094. eCollection 2019.

A case of small-cell lung cancer with adrenocorticotropic hormone deficiency induced by nivolumab.

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Department of Oncology, Peking University First Hospital, Beijing, China,
Department of Endocrinology, Peking University First Hospital, Beijing, China.


Anti-programmed death-1 (anti-PD-1) monoclonal antibodies, such as nivolumab, have been used for the treatment of various types of cancers, and excellent efficacy has been shown in some patients. The adverse effects of anti-PD-1 antibodies relating to autoimmunity are different from traditional chemotherapeutic drugs and may involve many organs including the endocrine system. We herein describe a case of adrenocorticotropic hormone deficiency during the treatment of advanced small-cell lung cancer, probably caused by nivolumab-induced hypophysitis. The case showed nonspecific, insidious, as well as potentially life-threatening characters of immune-related adverse effects. It is important for physicians to acknowledge clinical features of the rare side effect and take appropriate and prompt treatment.


ACTH deficiency; PD-1 inhibitor; hypophysitis; immune checkpoint inhibitor; immune-related adverse events

Conflict of interest statement

Disclosure The authors report no conflicts of interest in this work.

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