Garcia JA, Alcaraz D, Holgado E, Couñago F. Pembrolizumab autoimmune related diabetes: Moving forward, keep learning. World J Clin Oncol 2024; 15(5): 576-579 [PMID: 38835848 DOI: 10.5306/wjco.v15.i5.576]
Corresponding Author of This Article
Jose Angel Garcia, MMed, Attending Doctor, Department of Medical Oncology, GenesisCare Spain-San Francisco de Asis University Hospital, Joaquin Costa 28, Madrid 28002, Spain. jose.garcia@genesiscare.es
Research Domain of This Article
Oncology
Article-Type of This Article
Editorial
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Oncol. May 24, 2024; 15(5): 576-579 Published online May 24, 2024. doi: 10.5306/wjco.v15.i5.576
Pembrolizumab autoimmune related diabetes: Moving forward, keep learning
Jose Angel Garcia, Diego Alcaraz, Esther Holgado, Felipe Couñago
Jose Angel Garcia, Diego Alcaraz, Department of Medical Oncology, GenesisCare Spain-San Francisco de Asis University Hospital, Madrid 28002, Spain
Esther Holgado, Department of Chief of Medical Oncology, GenesisCare Spain-San Francisco de Asis University Hospital, Madrid 28002, Spain
Felipe Couñago, Department of Chief of Radiation Oncology, Genesiscare-San Francisco de Asis University Hospital, Madrid 28002, Spain
Felipe Couñago, Department of Chief of Radiation Oncology, GenesisCare-Vithas La Milagrosa Hospital, Madrid 28010, Spain
Author contributions: Garcia JA, Alcaraz D, Holgado E and Couñago F contributed equally to this work; Garcia JA, Alcaraz D, Holgado E and Couñago F wrote the manuscript; All authors have read and approve the final manuscript.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: Https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Jose Angel Garcia, MMed, Attending Doctor, Department of Medical Oncology, GenesisCare Spain-San Francisco de Asis University Hospital, Joaquin Costa 28, Madrid 28002, Spain. jose.garcia@genesiscare.es
Received: November 30, 2023 Revised: February 25, 2024 Accepted: April 8, 2024 Published online: May 24, 2024
Abstract
Immune checkpoint inhibitors (and more specifically programmed cell death 1/programmed cell death ligand 1 inhibitors as Pembrolizumab) initiated a revolution in the field of melanoma and have now expanded to several tumor subtypes and in increasingly broader clinical contexts, including the adjuvant and neoadjuvant setting, with potentially curable patients and prolonged survival. The side effects related to these drugs include a wide spectrum of manifestations, with endocrinological adverse events being some of the most frequent. Pembrolizumab-induced type 1 diabetes mellitus is an infrequent but potentially serious and not clearly reversible side effect that possesses characteristic clinical features and has high morbidity and mortality, with a chronic impact on quality of life. The etiopathogenesis of this phenomenom needs to be further investigated and a collaborative effort through the involvement of oncologists and other medical specialists is necessary for the correct identification and management of patients at risk.
Core Tip: Pembrolizumab-induced type 1 diabetes mellitus is a rare and potentially serious adverse event of immunotherapy, with a significant number of cases debuting abruptly and in a state of diabetic ketoacidosis without clear predisposing factors. Further research and strict follow-up by oncologists are fundamental tools for prevention and early treatment focusing on reducing the morbidity and mortality associated with this side effect.
