Adverse events associated with immune checkpoint inhibitors: a new era in autoimmune diabetes. Issue 4 (August 2020)

• Record Type: Journal Article
• Authors: Akturk, Halis Kaan; Michels, Aaron W.
• Is Part Of: Current opinion in endocrinology, diabetes and obesity. Volume 27:Issue 4(2020:Aug.)
• Publication Date: 2020-08
• Subjects: autoimmune diabetes -- cancer -- immune checkpoint inhibitor-induced diabetes -- immune checkpoint inhibitors -- immunotherapy -- nivolumab -- pembrolizumab -- type 1 diabetes; Endocrinology -- Periodicals; Diabetes -- Periodicals; Obesity -- Periodicals; Diabetes Mellitus -- Periodicals; Endocrine System Diseases -- Periodicals; Endocrine Glands -- Periodicals; Obesity -- Periodicals; Endocrinologie -- Périodiques; Diabète -- Périodiques; Obésité -- Périodiques; Diabetes; Endocrinology; Obesity; Periodicals; 616.4
• DOI: 10.1097/MED.0000000000000546
• Languages: English
• ISSNs: 1752-296X

Abstract

Abstract : Purpose of review: To summarize a new form of autoimmune diabetes as an adverse event of specific cancer immunotherapies. Immune checkpoint inhibitors are revolutionary treatments in advanced cancers; however, they can cause type 1 diabetes following treatment with these state-of-the-art therapies. Recent findings: A review of the literature showed that this new form of autoimmune diabetes has significant similarities with childhood-onset type 1 diabetes but also some distinctions. It frequently presents with severe diabetic ketoacidosis and almost half of the patients have type 1 diabetes-associated antibodies at presentation. Rapid loss of residual beta-cell function with a lack of honeymoon phase is typical. Certain human leukocyte antigen risk genes for prototypical type 1 diabetes that develops in children and young adults are also commonly found in patients with immune checkpoint inhibitor-induced type 1 diabetes. Summary: Immune checkpoint inhibitor-induced type 1 diabetes presenting with diabetic ketoacidosis is a life-threatening adverse event of cancer immunotherapy. Healthcare providers should be aware of this adverse event to prevent morbidity and mortality related to diabetic ketoacidosis. Developing guidelines to identify and monitor risk groups are of utmost importance.