Immune Checkpoint Inhibitor-Associated Type 1 Diabetes Mellitus: Case Series, Review of the Literature, and Optimal Management. Case Rep Oncol 2017;10(3):897-909
Date
12/28/2017Pubmed ID
29279690Pubmed Central ID
PMC5731100DOI
10.1159/000480634Scopus ID
2-s2.0-85031826225 (requires institutional sign-in at Scopus site) 50 CitationsAbstract
With the introduction of immune checkpoint inhibitors into clinical practice, various autoimmune toxicities have been described. Antibodies targeting the receptor:ligand pairing of programmed death receptor-1 (PD-1) and its cognate ligand programmed death-ligand 1 (PD-L1) in rare reports have been associated with autoimmune diabetes mellitus. We report 2 cases of rapid-onset, insulin-dependent, type 1 diabetes mellitus in the setting of administration of nivolumab, a fully human monoclonal antibody to PD-1, and atezolizumab, a humanized monoclonal antibody to PD-L1. This appears to be the first report of autoimmune diabetes mellitus associated with atezolizumab. In addition, we provide a brief review of similar cases reported in the literature and a discussion of potential mechanisms for this phenomenon and propose a diagnostic and treatment algorithm.
Author List
Kapke J, Shaheen Z, Kilari D, Knudson P, Wong SAuthors
Deepak Kilari MD Associate Professor in the Medicine department at Medical College of WisconsinPaul Knudson MD Associate Professor in the Medicine department at Medical College of Wisconsin
Stuart J. Wong MD Center Director, Professor in the Medicine department at Medical College of Wisconsin
