Development of diabetes mellitus on the background of immunotherapy in patients with malignant neoplasms: A retrospective study

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Abstract

Background. Endocrinopathies are a subset of immune-related adverse events (irAEs) associated with immune checkpoint inhibitor (ICTI) immunotherapy, of which diabetes mellitus (irDM) is one of the most serious.

Aim. To describe peculiarities of DM development against the background of immunotherapy in patients with malignant neoplasms on the example of a series of clinical cases.

Materials and methods. Seven patients with melanoma, non-small-cell lung cancer and renal cancer aged 43 to 69 years, who developed DM against the background of immunotherapy (nivolumab, ipilimumab, pembrolizumab, atezolizumab both as monotherapy and combined treatment) were included in the retrospective study.

Results. Partial response was observed in 1 patient, stabilization – in 6 patients. The median of time before the development of DM was 10.13 months. Complications of DM were observed in 4 patients, and other irAEs developed in 5 patients. Fatal outcome was observed in 2 patients, due to progression of the underlying disease (1 patient) and development of coma due to insulin-dependent DM (1 patient).

Conclusion. IrDM is a rare but extremely serious complication of ICTI therapy that requires clear definition of diagnostic criteria. Identification of premorbid predictors of irDM may allow for targeted treatment trials and earlier detection of this complication of ICTI therapy.

About the authors

Marina A. Lyadova

Moscow State Budgetary Healthcare Institution «Moscow City Hospital named after S.S. Yudin, Moscow Healthcare Department»; Novokuznetsk State Institute for Further Training of Physicians – Branch Campus of the Russian Medical Academy of Continuous Professional Education

Author for correspondence.
Email: dr.lyadova@gmail.com
ORCID iD: 0000-0002-9558-5579
SPIN-code: 8220-2854

Cand. Sci. (Med.) 

Russian Federation, Moscow; Novokuznetsk

Olesya A. Pardabekova

Moscow State Budgetary Healthcare Institution «Moscow City Hospital named after S.S. Yudin, Moscow Healthcare Department»

Email: dr.lyadova@gmail.com
ORCID iD: 0000-0001-5610-4595

Oncologist

Russian Federation, Moscow

Denis S. Fedorinov

Russian Medical Academy of Continuous Professional Education; Petrovsky National Research Center of Surgery; Moscow Multidisciplinary Clinical Center "Kommunarka"

Email: dr.lyadova@gmail.com
ORCID iD: 0000-0001-5516-7367
SPIN-code: 1079-8460

Oncologist

Russian Federation, Moscow; Moscow; Moscow

Tatiana G. Antonova

Moscow State Budgetary Healthcare Institution «Moscow City Hospital named after S.S. Yudin, Moscow Healthcare Department»

Email: dr.lyadova@gmail.com
ORCID iD: 0009-0007-6646-7454

Оncologist, Head of Day Hospital

Russian Federation, Moscow

Elina A. Khachaturian

Moscow State Budgetary Healthcare Institution «Moscow City Hospital named after S.S. Yudin, Moscow Healthcare Department»

Email: dr.lyadova@gmail.com
ORCID iD: 0009-0002-4945-9181
SPIN-code: 3101-4168

Oncologist

Russian Federation, Moscow

Maxim M. Sobolev

Moscow State Budgetary Healthcare Institution «Moscow City Hospital named after S.S. Yudin, Moscow Healthcare Department»

Email: dr.lyadova@gmail.com
ORCID iD: 0009-0000-9717-1700

Oncologist

Russian Federation, Moscow

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