Combined immune checkpoint inhibitor therapy with nivolumab and ipilimumab causing acute-onset type 1 diabetes mellitus following a single administration: two case reports

Autor: Marco Zezza, Nelly Pitteloud, Haithem Chtioui, Laura Marino, Faiza Lamine, Carine Mekoguem, Christophe Kosinski
Jazyk: angličtina
Rok vydání: 2019
Předmět:
Male
Oncology
medicine.medical_specialty
Skin Neoplasms
Combination therapy
Diabetic ketoacidosis
endocrine system diseases
Endocrinology
Diabetes and Metabolism
Case Report
Ipilimumab
Type 2 diabetes
Immune checkpoint inhibitor
lcsh:Diseases of the endocrine glands. Clinical endocrinology
03 medical and health sciences
Antineoplastic Agents
Immunological
0302 clinical medicine
Diabetes mellitus
Internal medicine
Antineoplastic Combined Chemotherapy Protocols
medicine
Humans
030212 general & internal medicine
Endocrinopathies
Melanoma
Autoimmune adverse events
Aged
80 and over
Type 1 diabetes
lcsh:RC648-665
business.industry
Type 2 Diabetes Mellitus
General Medicine
Middle Aged
medicine.disease
Acute Disease
Antineoplastic Agents
Immunological/administration & dosage
Antineoplastic Agents
Immunological/adverse effects
Antineoplastic Combined Chemotherapy Protocols/administration & dosage
Antineoplastic Combined Chemotherapy Protocols/adverse effects
Diabetes Mellitus
Type 1/chemically induced
Diabetes Mellitus
Type 1/diagnosis
Diabetes Mellitus
Type 1/pathology
Female
Ipilimumab/administration & dosage
Ipilimumab/adverse effects
Melanoma/drug therapy
Melanoma/pathology
Nivolumab/administration & dosage
Nivolumab/adverse effects
Skin Neoplasms/drug therapy
Skin Neoplasms/pathology
Diabetes Mellitus
Type 1
Nivolumab
030220 oncology & carcinogenesis
business
medicine.drug
Zdroj: BMC Endocrine Disorders, Vol 19, Iss 1, Pp 1-5 (2019)
BMC Endocrine Disorders
BMC endocrine disorders, vol. 19, no. 1, pp. 144
ISSN: 1472-6823
Popis: BackgroundThe use of immune checkpoint inhibitor (ICI) therapy is becoming a standard of care for several cancers. Monoclonal antibodies targeting cytotoxic T-lymphocyte antigen-4 (CTLA-4) and programmed cell death protein 1 (PD-1) or its ligand (PD-L1) cause a broad spectrum of autoimmune adverse events. ICI-induced type 1 diabetes mellitus (T1DM) is extremely rare (Cases presentationWe report an acute onset T1DM with severe inaugural diabetic ketoacidosis (DKA) and remarkably elevated Glutamic Acid Decarboxylase antibody (GADA) titres following a single administration of combined ICI therapy with nivolumab (anti-PD-1) and ipilimumab (anti-CTLA-4) in two adult patients with advanced metastatic melanoma. In these cases, the time to diabetes onset was remarkably short (two and five weeks), and one presented with fulminous T1DM in a previous long-standing type 2 diabetes mellitus.ConclusionsOncological patients treated with combination therapy of anti-PD-1 and anti-CTLA-4 can develop a particular pattern of T1DM, with very rapid onset within a few weeks after starting ICI therapy, even in the presence of an existing type 2 diabetes. ICI-induced T1DM is a medical emergency in presence of severe inaugural DKA and requires a collaboration between specialists and primary care physicians, as well as patient education, for early diagnosis and supportive care.
Databáze: OpenAIRE
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