Most men with malignant melanoma who were treated with immunotherapy were found to have low testosterone, according to the results of a retrospective study published in Oncotarget.
Study researchers used patient charts to identify 49 individuals with malignant melanoma who had been treated with immunotherapy. Nearly all patients had stage 3 or 4 disease; 1 patient had primary pineal gland melanoma. Immunotherapy treatments included pembrolizumab, ipilimumab, nivolumab, or the investigational agents indoximod and SD-101.
Among 49 patients, 34 had low testosterone during immunotherapy treatment, 10 of whom had normal testosterone levels before starting immunotherapy.
Low testosterone levels resolved for only 4 of the 10 patients who had normal testosterone levels at baseline. A total of 25 of 34 patients who had low testosterone during treatment did not have a complete recovery of their testosterone levels during the follow-up period. The testosterone levels of only 1 patient were found to have returned to normal after 1 year.
Hypophysitis that led to hypopituitarism was seen in 4 patients. Among these patients, all underwent treatment with ipilimumab and showed signs of hypopituitarism after 2 or 3 doses. As treatment, 3 patients received testosterone replacement therapy and 1 patient received corticosteroids.
“These data suggest that patients being treated with ipilimumab need diligent monitoring of their endocrine function during the first three months of their treatment and up to 12 months after completion of their immunotherapy treatment,” the study researchers wrote.
The study researchers concluded that patients with stage 3 or 4 melanoma treated with immunotherapy appear to be at increased risk of developing testosterone deficiency during treatment.
Peters M, Pearlman A, Terry W, Mott SL, Monga V. Testosterone deficiency in men receiving immunotherapy for malignant melanoma. Oncotarget. 2021;12(3):199-208. doi:10.18632/oncotarget.27876