Case report: pembrolizumab-induced Type 1 diabetes in a patient with metastatic cholangiocarcinoma

Authors

Matthew A. Smith-Cohn, Department of Neurology, University of Utah, Salt Lake City, 175 North Medical Drive East, UT 84132, USA.Follow
David Gill, Department of Hematology and Oncology, University of Utah School of Medicine, Huntsman Cancer Institute, 2000 Circle of Hope, Salt Lake City, UT 84112, USA.
Benjamin N. Voorhies, Department of Hematology and Oncology, University of Utah School of Medicine, Huntsman Cancer Institute, 2000 Circle of Hope, Salt Lake City, UT 84112, USA.
Neeraj Agarwal, Department of Hematology and Oncology, University of Utah School of Medicine, Huntsman Cancer Institute, 2000 Circle of Hope, Salt Lake City, UT 84112, USA.
Ignacio Garrido-Laguna, Department of Hematology and Oncology, University of Utah School of Medicine, Huntsman Cancer Institute, 2000 Circle of Hope, Salt Lake City, UT 84112, USA.

Document Type

Article

Abstract

BACKGROUND: Immune checkpoint inhibitors are novel cancer therapies associated with numerous autoimmune toxicities, some of which are only now being appreciated. CASE PRESENTATION: A 67-year old female with metastatic cholangiocarcinoma and no prior history of diabetes was treated with leucovorin, fluorouracil, oxaliplatin and pembrolizumab. After eight cycles, she developed new onset type 1 diabetes mellitus with positive glutamic acid decarboxylase antibody titers. Conclusions: To our knowledge, this is the first reported case of PD-1 inhibitor associated Type 1 diabetes mellitus in a patient with cholangiocarcinoma and supports others' experiences that PD-1 inhibition can cause a spectrum of autoimmune adverse events that require clinical monitoring and periodic screenings.

Medical Subject Headings

Aged; Antibodies, Monoclonal, Humanized (adverse effects, therapeutic use); Antineoplastic Agents, Immunological (adverse effects, therapeutic use); Bile Duct Neoplasms (diagnosis, drug therapy); Cholangiocarcinoma (diagnosis, drug therapy); Diabetes Mellitus, Type 1 (diagnosis, etiology); Drug-Related Side Effects and Adverse Reactions (diagnosis); Female; Humans; Immunotherapy (methods); Neoplasm Metastasis; Programmed Cell Death 1 Receptor (immunology)

Publication Date

9-1-2017

Publication Title

Immunotherapy

E-ISSN

1750-7448

Volume

9

Issue

10

First Page

797

Last Page

804

PubMed ID

28877632

Digital Object Identifier (DOI)

10.2217/imt-2017-0042

Recommended Citation

Smith-Cohn, Matthew A.; Gill, David; Voorhies, Benjamin N.; Agarwal, Neeraj; and Garrido-Laguna, Ignacio, "Case report: pembrolizumab-induced Type 1 diabetes in a patient with metastatic cholangiocarcinoma" (2017). Neurology. 1744.
https://scholar.barrowneuro.org/neurology/1744