End‐of‐life impact of concurrent diabetes mellitus and adrenal insufficiency as immune‐related adverse events in an advanced non‐small cell lung cancer patient. Issue 21 (4th October 2022)

• Record Type: Journal Article
• Authors: Nakamura, Tomoaki; Takeyasu, Yuki; Yoshida, Tatsuya; Ohashi, Ken; Ohe, Yuichiro
• Is Part Of: Thoracic cancer. Volume 13:Issue 21(2022)
• Page Start: 3073
• Page End: 3075
• Publication Date: 2022-10-04
• Subjects: case report -- end of life -- immune checkpoint inhibitors -- immune‐related adverse events -- non‐small cell lung cancer; Chest -- Cancer -- Periodicals; Chest -- Cancer -- Treatment -- Periodicals; Chest -- Surgery -- Periodicals; 616.99494005
• DOI: 10.1111/1759-7714.14660
• Languages: English
• ISSNs: 1759-7706

Abstract

Abstract: A 49‐year‐old man diagnosed with metastatic non‐small cell lung cancer was treated with immune checkpoint inhibitor (ICI) combination therapy (nivolumab + ipilimumab) as first‐line therapy. During the treatment course, the patient developed ICI‐associated diabetes mellitus and adrenal insufficiency, and insulin and hydrocortisone replacement therapy (10 mg/day) were initiated for endocrine toxicity. Despite systemic treatment, the disease progressed. Near the end of the patient's life, he was repeatedly hospitalized for diabetic ketoacidosis and adrenal crisis because he could not physically administer insulin subcutaneously or self‐administer oral hydrocortisone due to the deterioration of his general condition as a result of disease progression. This case report demonstrates that it is necessary to evaluate not only the impact of immune‐related adverse events on short‐term quality of life during ICI treatment but also on the patient's end‐of‐life care. Abstract : Immune checkpoint inhibitors (ICIs) can cause a unique spectrum of side effects termed immune‐related adverse events. We encountered a case of ICI‐associated diabetes mellitus and adrenal insufficiency caused by treatment with ICIs that were difficult to manage near the end of life. It is necessary to evaluate not only the impact of immune‐related adverse events on short‐term quality of life during ICI treatment but also on the patient's end‐of‐life care.