Pembrolizumab Dual Endocrine Toxicity in a Metastatic Non-small Cell Lung Cancer Patient

Immune checkpoint inhibitors can cause endocrine toxicities, although involvement of multiple hormonal axes is uncommon. Hypophysitis associated with programmed death-1 inhibitors such as pembrolizumab may lead to life-threatening central adrenal insufficiency and can present diagnostic challenges. We present the case of a 58-year-old woman with metastatic non-small cell lung cancer who developed pembrolizumab-induced hypophysitis resulting in central adrenal insufficiency with delayed recognition, and concurrent immune-related thyroiditis.