title: A case of pembrolizumab-induced type-1 diabetes mellitus and discussion of immune checkpoint inhibitor-induced type 1 diabetes.
abstract: Immune checkpoint inhibitors such as pembrolizumab, ipilimumab, and nivolumab, now FDA-approved for use in treating several types of cancer, have been associated with immune-related adverse effects. Specifically, the antibodies targeting the programmed-cell death-1 immune checkpoint, pembrolizumab and nivolumab, have been rarely reported to induce the development of type 1 diabetes mellitus. Here we describe a case of a patient who developed antibody-positive type 1 diabetes mellitus following treatment with pembrolizumab in combination with systemic chemotherapy for metastatic adenocarcinoma of the lung. We will also provide a brief literature review of other rarely reported cases of type 1 diabetes presenting after treatment with pembrolizumab and nivolumab, as well as discussion regarding potential mechanisms of this adverse effect and its importance as these drugs continue to become even more widespread.
authors.affiliation: Developmental Therapeutics Program of the Division of Hematology/Oncology, Northwestern University, Chicago, IL, 60611, USA. young.chae@northwestern.edu.|Robert H. Lurie Comprehensive Cancer Center of Northwestern University, Chicago, IL, 60611, USA. young.chae@northwestern.edu.|Feinberg School of Medicine, Northwestern University, 645 N. Michigan Ave, Suite 1006, Chicago, IL, 60611, USA. young.chae@northwestern.edu.
authors.forename: Young Kwang
authors.initials: YK
authors.lastname: Chae
authors.affiliation: Feinberg School of Medicine, Northwestern University, 645 N. Michigan Ave, Suite 1006, Chicago, IL, 60611, USA.
authors.forename: Lauren
authors.initials: L
authors.lastname: Chiec
authors.affiliation: Developmental Therapeutics Program of the Division of Hematology/Oncology, Northwestern University, Chicago, IL, 60611, USA.|Robert H. Lurie Comprehensive Cancer Center of Northwestern University, Chicago, IL, 60611, USA.|Feinberg School of Medicine, Northwestern University, 645 N. Michigan Ave, Suite 1006, Chicago, IL, 60611, USA.
authors.forename: Nisha
authors.initials: N
authors.lastname: Mohindra
authors.affiliation: University of Virginia School of Medicine, Charlottesville, VA, 22908-0395, USA.
authors.forename: Ryan
authors.initials: R
authors.lastname: Gentzler
authors.affiliation: Robert H. Lurie Comprehensive Cancer Center of Northwestern University, Chicago, IL, 60611, USA.|Feinberg School of Medicine, Northwestern University, 645 N. Michigan Ave, Suite 1006, Chicago, IL, 60611, USA.|The University of Chicago Medicine, Chicago, IL, 60637, USA.
authors.forename: Jyoti
authors.initials: J
authors.lastname: Patel
authors.affiliation: Developmental Therapeutics Program of the Division of Hematology/Oncology, Northwestern University, Chicago, IL, 60611, USA.|Robert H. Lurie Comprehensive Cancer Center of Northwestern University, Chicago, IL, 60611, USA.|Feinberg School of Medicine, Northwestern University, 645 N. Michigan Ave, Suite 1006, Chicago, IL, 60611, USA.
authors.forename: Francis
authors.initials: F
authors.lastname: Giles
mesh_terms: D000368:Aged; D061067:Antibodies, Monoclonal, Humanized / Q000008:administration & dosage / Q000009:adverse effects*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects; D059447:Cell Cycle Checkpoints / Q000276:immunology; D003922:Diabetes Mellitus, Type 1 / Q000139:chemically induced* / Q000276:immunology*; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy / Q000276:immunology; D008297:Male
chemical_list: D061067:Antibodies, Monoclonal, Humanized; C582435:pembrolizumab
keywords: Diabetes mellitus; Immune-related adverse effect; Immunomodulatory; Ipilimumab; Nivolumab; Pembrolizumab