Special attention should be paid with regard to the patients receiving combination therapies including anti-CTLA-4 therapies: it has been shown that such combinations may trigger hypophysitis more frequently due to the ectopic expression of the CTLA-4 molecule in the pituitary gland cells, leading to direct damage that is difficult to treat if unnoticed at the initiation [101]. This evidence concerns the gene CTLA4 and hypophysitis.