Pembrolizumab-induced diabetes

Banatwalla, Rumaisa; Kirresh, Omar; Ahmed, Fahad

doi:10.5603/ep.a2021.0053

Cited by 3 publications

(1 citation statement)

References 6 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Other studies showed that common cancer-fighting program death 1 (PD-1) and program death ligand 1 (PDL-1) inhibitors have been shown to have numerous autoimmune endocrine side effects such as drug-induced T1DM [ 12 , 13 ]. Pembrolizumab, a humanized monoclonal antibody against PD-1 used in the treatment of common cancers such as melanoma, lung cancer, and Hodgkin lymphoma, is one such example of a drug that was implicated in the induction of T1DM [ 14 ]. In these instances, the prescribed theory attributes the induction of autoimmune destruction of endogenous hormones to the drugs’ capability to bind off-target tissue or hormone epitopes, which produces the undesired side effect [ 15 ].…”

Section: Discussionmentioning

confidence: 99%

Dupilumab-Related Diabetes Mellitus With Reversal of Symptoms in a Non-genetically Predisposed Patient

Blaylock,

Leon

2024

Cureus

View full text Add to dashboard Cite

Dupilumab is a fully humanized monoclonal antibody that binds to IL-4 receptors and blocks IL-4 and IL-13 mediated T-helper 2 (Th2) responses. Dupilumab is estimated to be used by over 600,000 patients worldwide for the treatment of atopic dermatitis and other immunologic conditions. Recently, a 66-year-old male patient being treated for atopic dermatitis with dupilumab presented to the clinic with complaints of polyuria and polydipsia. Upon initial testing, the patient was found to have considerable hyperglycemia. Upon genetic testing, he showed no predisposition for autoimmune diabetes and was negative for type I diabetes mellitus-associated human leukocyte antigen (HLA) genes. After immediate cessation of dupilumab, and with subsequent insulin therapy, the patient was able to obtain glycemic control. Following taper and eventual cessation of insulin therapy and over the course of seven months, the patient was able to achieve a full resolution of symptoms and his glycosylated hemoglobin (HgBA1c) levels returned to normal ranges. This case represents only the second documented case of dupilumab-induced diabetes mellitus and is the first known documented case of dupilumab-induced diabetes mellitus in a non-genetically predisposed individual. This case also describes a previously unobserved spontaneous resolution of symptoms upon cessation of the drug. This case further illustrates the potential existence of immunogenic or immunomodulatory side effects of the monoclonal antibody dupilumab that can affect patients who are both genetically and non-genetically predisposed to autoimmune diabetes mellitus.

show abstract

Section: Discussionmentioning

confidence: 99%

Dupilumab-Related Diabetes Mellitus With Reversal of Symptoms in a Non-genetically Predisposed Patient

Blaylock,

Leon

2024

Cureus

View full text Add to dashboard Cite

show abstract

Pembrolizumab

2021

Reactions Weekly

View full text Add to dashboard Cite

Autoimmune diabetes from pembrolizumab: A case report and review of literature

Bhanderi,

Khalid,

Bodla

et al. 2023

World J Clin Oncol

View full text Add to dashboard Cite

BACKGROUND Immunotherapy, specifically the use of checkpoint inhibitors such as pembrolizumab, has become an important tool in personalized cancer therapy. These inhibitors target proteins on T-cells that regulate the immune response against tumor cells. Pembrolizumab, which targets the programmed cell death 1 receptor on T-cells, has been approved for the treatment of metastatic melanoma and non-small cell lung cancer. However, it can also lead to immune-related side effects, including pneumonitis, colitis, thyroid abnormalities, and rare cases of type 1 diabetes. CASE SUMMARY The case presented involves an adult patient in 30s with breast cancer who developed hyperglycemia after receiving pembrolizumab treatment. The patient was diagnosed with diabetic ketoacidosis and further investigations were performed to evaluate for new-onset type 1 diabetes. The patient had a history of hypothyroidism and a family history of breast cancer. Treatment for diabetic ketoacidosis was initiated, and the patient was discharged for close follow-up with an endocrinologist. CONCLUSION This literature review highlights the occurrence of diabetic ketoacidosis and new-onset type 1 diabetes in patients receiving pembrolizumab treatment for different types of cancer. Overall, the article emphasizes the therapeutic benefits of immunotherapy in cancer treatment, particularly pembrolizumab, while also highlighting the potential side effect of immune-related diabetes that can occur in a small percentage of patients. Here we present a case where pembrolizumab lead to development of diabetes after a few cycles highlighting one of the rare yet a serious toxicity of the drug.

show abstract

Pembrolizumab-induced diabetes

Cited by 3 publications

References 6 publications

Dupilumab-Related Diabetes Mellitus With Reversal of Symptoms in a Non-genetically Predisposed Patient

Dupilumab-Related Diabetes Mellitus With Reversal of Symptoms in a Non-genetically Predisposed Patient

Pembrolizumab

Autoimmune diabetes from pembrolizumab: A case report and review of literature

Contact Info

Product

Resources

About