病例报告：帕博利珠单抗诱导转移性胆管癌患者发生1型糖尿病。
Case report: pembrolizumab-induced Type 1 diabetes in a patient with metastatic cholangiocarcinoma.
作者信息
Smith-Cohn Matthew A, Gill David, Voorhies Benjamin N, Agarwal Neeraj, Garrido-Laguna Ignacio
机构信息
Department of Neurology, University of Utah, Salt Lake City, 175 North Medical Drive East, UT 84132, USA.
Department of Hematology and Oncology, University of Utah School of Medicine, Huntsman Cancer Institute, 2000 Circle of Hope, Salt Lake City, UT 84112, USA.
出版信息
Immunotherapy. 2017 Sep;9(10):797-804. doi: 10.2217/imt-2017-0042.
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.
背景
免疫检查点抑制剂是一类新型癌症治疗药物，与多种自身免疫毒性相关，其中一些毒性直到现在才被认识到。
病例介绍
一名67岁女性，患有转移性胆管癌，既往无糖尿病史，接受了亚叶酸钙、氟尿嘧啶、奥沙利铂和帕博利珠单抗治疗。八个周期后，她出现了新发的1型糖尿病，谷氨酸脱羧酶抗体滴度呈阳性。结论：据我们所知，这是首例报道的胆管癌患者中与PD-1抑制剂相关的1型糖尿病病例，并支持了其他人的经验，即PD-1抑制可导致一系列自身免疫不良事件，需要临床监测和定期筛查。
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