Cheema Anmol, Makadia Bhaktidevi, Karwadia Tejas, Bajwa Ravneet, Hossain Mohammad
Jersey Shore University Medical Center, Neptune, NJ, USA.
World J Oncol. 2018 Feb;9(1):1-4. doi: 10.14740/wjon1085w. Epub 2018 Mar 8.
The utility of immunotherapy, such as pembrolizumab, is becoming essential in the treatment of certain cancers. Pembrolizumab works through binding of programmed cell death 1 receptor that blocks the binding of the programmed cell death ligand 1 and is commonly used in non-small cell lung cancer and melanoma. Pembrolizumab has been reported to be associated with multiple adverse reactions such as pneumonitis, colitis, hepatitis, hypophysitis, hyperthyroidism, hypothyroidism, nephritis, and type 1 diabetes; however, pembrolizumab causing type 1 diabetes was only reported in 0.1% of the patients in clinical trials. A review of the literature generated 1,001 unique citations of which six reported cases of autoimmune diabetes associated with pembrolizumab were selected and compared. Review of the cases showed no sexual predilection and the average age of onset was 58 years old. The majority of the patients were treated for melanoma (5/6 cases), initially presented with diabetic ketoacidosis (4/6 cases), and had at one point taken ipilimumab (4/6 cases). There was no association found between the number of treatments received and the development of diabetes. With the increasing use of pembrolizumab in cancer treatment regular blood glucose monitoring during treatment, especially in patients who had also taken ipilimumab, may prevent the onset of this life-threatening complication.
免疫疗法，如帕博利珠单抗，在某些癌症的治疗中变得至关重要。帕博利珠单抗通过与程序性细胞死亡1受体结合发挥作用，该受体可阻断程序性细胞死亡配体1的结合，常用于非小细胞肺癌和黑色素瘤的治疗。据报道，帕博利珠单抗与多种不良反应相关，如肺炎、结肠炎、肝炎、垂体炎、甲状腺功能亢进、甲状腺功能减退、肾炎和1型糖尿病；然而，在临床试验中，仅0.1%的患者报告帕博利珠单抗导致1型糖尿病。对文献的回顾产生了1001条独特的引用，从中选择并比较了6例报告的与帕博利珠单抗相关的自身免疫性糖尿病病例。对这些病例的回顾显示无性别倾向，平均发病年龄为58岁。大多数患者接受黑色素瘤治疗（6例中的5例），最初表现为糖尿病酮症酸中毒（6例中的4例），并且曾一度使用过伊匹木单抗（6例中的4例）。未发现接受治疗的次数与糖尿病的发生之间存在关联。随着帕博利珠单抗在癌症治疗中的使用增加，在治疗期间定期监测血糖，尤其是在同时使用过伊匹木单抗的患者中，可能会预防这种危及生命的并发症的发生。
