Diabetic Ketoacidosis as an Immune-related Adverse Event from Pembrolizumab in Non-Small Cell Lung Cancer

J Immunother. 2017 Jul/Aug;40(6):249-251. doi: 10.1097/CJI.0000000000000173.

Abstract

Programmed cell death protein 1 pathway inhibitors are now routinely administered to patients with non-small cell lung cancer, and prompt recognition of immune-related adverse events is critical to managing serious drug toxicities. Here, we describe a 66-year-old man with no known history of diabetes who presented with diabetic ketoacidosis after receiving 3 doses of pembrolizumab for lung adenocarcinoma. Autoimmune diabetes is a rare but potentially life-threatening complication of programmed cell death protein 1 inhibitors.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Antibodies, Monoclonal, Humanized / adverse effects
  • Antibodies, Monoclonal, Humanized / therapeutic use*
  • Antineoplastic Agents / adverse effects
  • Antineoplastic Agents / therapeutic use*
  • Autoantibodies / blood
  • Carcinoma, Non-Small-Cell Lung / complications
  • Carcinoma, Non-Small-Cell Lung / diagnosis*
  • Carcinoma, Non-Small-Cell Lung / drug therapy
  • Diabetic Ketoacidosis / diagnosis*
  • Diabetic Ketoacidosis / drug therapy
  • Diabetic Ketoacidosis / etiology
  • Drug-Related Side Effects and Adverse Reactions / diagnosis*
  • Glutamate Decarboxylase / immunology
  • Humans
  • Immunotherapy / adverse effects
  • Immunotherapy / methods*
  • Insulin / therapeutic use
  • Lung Neoplasms / complications
  • Lung Neoplasms / diagnosis*
  • Lung Neoplasms / drug therapy
  • Male
  • Programmed Cell Death 1 Receptor / immunology
  • Remission Induction

Substances

  • Antibodies, Monoclonal, Humanized
  • Antineoplastic Agents
  • Autoantibodies
  • Insulin
  • Programmed Cell Death 1 Receptor
  • pembrolizumab
  • Glutamate Decarboxylase
  • glutamate decarboxylase 2