Anti PD-1 monoclonal antibody induced autoimmune diabetes mellitus: a case report and brief review.

Abstract

Nowadays, immune checkpoint inhibitor therapy has been used in more and more cancer patients. These agents were associated with immune-related adverse effects, and autoimmune diabetes mellitus is one of them. And it is not common but can be potentially fatal. Anti PD-1 monoclonal antibody is a humanized IgG4 antibody against PD-1, which has been applied in advanced non-small cell lung cancer (NSCLC) treatment. In this paper, we reported the case of autoimmune diabetes mellitus induced by anti PD-1 monoclonal antibody in NSCLC treatment. Here is a 73-year-old male patient with no diabetes history who had anti PD-1 monoclonal antibody 200 mg every 3 weeks for NSCLC treatment. After 10 cycles of the therapy, his blood glucose level elevated and he suffered diabetic ketoacidosis (DKA). And his C-peptide was significantly decreased with negative relative auto-antibodies. Combined with his medical history and the laboratory examination, anti PD-1 monoclonal antibody induced autoimmune diabetes mellitus was diagnosed. After recovering from DKA and controlling his blood glucose, his anti PD-1 therapy was continued and he still got some benefit. This report suggested that glycemic monitoring is imperative during this anti PD-1 monoclonal antibody treatment. Moreover, after controlling the blood glucose level, continuing the immune therapy could still be benefit and safe for the patient.

• Authors: Wei Li, Hao Wang, Bin Chen, Sha Zhao, Xiaoshen Zhang, Keyi Jia, Juan Deng, Yayi He, Caicun Zhou
• Journal: Translational lung cancer research (Transl Lung Cancer Res) Vol. 9 Issue 2 Pg. 379-388 (Apr 2020) ISSN: 2218-6751 [Print] China
• PMID: 32420079 (Publication Type: Case Reports)
• Copyright: 2020 Translational Lung Cancer Research. All rights reserved.