A case of pituitary crisis caused by cadonilimab treatment of advanced gastric cancer

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Affiliation: Department of Pharmacy, Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China

Keywords: Cadonilimab Pituitary crisis Immune-related adverse event Adverse drug reaction

DOI: 10.12173/j.issn.1005-0698.202312065

Reference: XU Qian, XU Ting.A case of pituitary crisis caused by cadonilimab treatment of advanced gastric cancer[J].Yaowu Liuxingbingxue Zazhi,2024, 33(1):116-120.DOI: 10.12173/j.issn.1005-0698.202312065.[Article in Chinese]  Copied

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Abstract

A 75-year-old female patient with gastric cancer received cadonilimab (500 mg, iv, d1) combined with albumin-bound paclitaxel (300 mg, iv, d2) and tegafur, gimeracil and oteracil potassium (40 mg, po, bid, d2-15) and 21 days was a cycle. Admission examination at the end of 4 cycles of treatment, laboratory tests showed adrenocorticotropic hormone <1.00 pg·mL^-1, cortisol 0.42 μg·dL^-1 and serum sodium 131 mmol·L^-1. Immune checkpoint inhibitor-related hypophysitis was diagnosed, and pituitary crisis was developed on the 4th day. The diagnosis of hypophysitis concurrent with pituitary crisis was considered to be related to cadonilimab. High-dose glucocorticoids replacement and symptomatic treatment such as rehydration to maintain electrolyte imbalance were given. On the 9th day after admission, the patient was basically in remission. The administration of cadonilimab may cause pituitary crisis, which is relatively rare in clinical practice. This case reminds that the possibility of hypophysitis when patients emerge with the symptom of fatigue and anorexia along with hyponatremia. Assessment of endocrine gland function, correct diagnosis and proper therapy are of significant clinical value to improve the patients' prognosis.

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