A case of fulminant Type 1 diabetes following anti-PD1 immunotherapy in a genetically susceptible patient.

Abstract:

:Programmed cell death-1 protein (PD-1) is an immune checkpoint that has gained popularity in the treatment of several advanced cancers. Inhibiting this checkpoint is known to enhance immune response, but is also known to diminish immune tolerance and to increase autoimmune toxicity. We discuss a case of rapid onset fulminant Type 1 diabetes induced by treatment with anti-programmed cell death-1 monoclonal antibody, nivolumab, in a patient with late-stage non-small-cell lung adenocarcinoma. The patient had no history of previous diabetes but did reveal a high-risk genotype for Type 1 diabetes development (DR3-DQ2; DR4-DQ8). This finding supports that acute Type 1 diabetes can be an important adverse effect of immunotherapies targeting T-cell activation regulation. Because of the severity of this adverse effect, physicians should be aware of it, and studies directed to the detection of new biomarkers for early risk stratification (e.g., HLA) should be sought.

journal_name

Immunotherapy

journal_title

Immunotherapy

authors

Araújo M,Ligeiro D,Costa L,Marques F,Trindade H,Correia JM,Fonseca C

doi

10.2217/imt-2017-0020

subject

Has Abstract

pub_date

2017-06-01 00:00:00

pages

531-535

issue

7

eissn

1750-743X

issn

1750-7448

journal_volume

9

pub_type

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