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Immune Checkpoint Inhibitor-Associated Type 1 Diabetes Mellitus: Case Series, Review of the Literature, and Optimal Management. Case Rep Oncol 2017 Sep-Dec;10(3):897-909

Date

12/28/2017

Pubmed ID

29279690

Pubmed Central ID

PMC5731100

DOI

10.1159/000480634

Scopus ID

2-s2.0-85031826225   37 Citations

Abstract

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 S

Authors

Deepak Kilari MD Associate Professor in the Medicine department at Medical College of Wisconsin
Paul 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