Department of Pharmacy, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, China.
Department of Pharmacy, Taizhou Municipal Hospital, Taizhou, China.
Front Endocrinol (Lausanne). 2021 Jan 28;11:608966. doi: 10.3389/fendo.2020.608966. eCollection 2020.
Diabetes and cancer are both multifactorial diseases, and epidemiologic evidence indicates that diabetes may be associated with the incidence of certain types of cancer. In diabetes the risk of pancreatic cancer is increased significantly. However, whether certain diabetes treatment being related with the risk of pancreatic cancer remains unclear. In this report, we presented a case of pancreatic ductal adenocarcinoma in a diabetic patient in China after being treated with liraglutide, a novel glucagon-like peptide-1 (GLP-1) analog.
A 71-year-old Han Chinese man who had had a type 2 diabetes for 25 years presented at the endocrinology department with discomfort in the left upper quadrant of abdomen for 10 days. The patient's vital signs and laboratory findings were unremarkable except for the elevated level of carbohydrate antigen (CA19-9). The upper abdomen routine enhanced computed tomography (CT) scan showed low density of the pancreatic body and tail, and the histopathological result of the pancreatic biopsy samples was pancreatic ductal adenocarcinoma with regional lymph node metastasis. We reviewed his former medical records and found that liraglutide was added to his hypoglycemic treatment regimen 20 months ago. At that time, the level of tumor biomarkers and upper abdomen routine CT were unremarkable. We estimated the causality between liraglutide and pancreatic cancer by the Naranjo Adverse Drug Reaction Probability scale and WHO-Uppsala Monitoring Centre (WHO-UMC) system, and the causality turned out to be possible.
Our report suggests that liraglutide may be related with the genesis and development of pancreatic cancer and also highlights the importance of regular checkups in diabetic patients treated with liraglutide. However, our report has some notable limitations, and further longer-term follow-up trials with larger sample should be conducted in future to assess the causality between liraglutide and pancreatic cancer.
糖尿病和癌症都是多因素疾病，流行病学证据表明糖尿病可能与某些类型癌症的发生有关。在糖尿病中，胰腺癌的风险显著增加。然而，某些糖尿病治疗方法是否与胰腺癌风险相关尚不清楚。在本报告中，我们报告了一例在中国使用新型胰高血糖素样肽-1（GLP-1）类似物利拉鲁肽治疗的糖尿病患者发生胰腺导管腺癌的病例。
一名 71 岁汉族男性，患有 25 年 2 型糖尿病，因左上腹不适 10 天就诊于内分泌科。患者生命体征和实验室检查除碳水化合物抗原（CA19-9）水平升高外无明显异常。上腹部常规增强 CT 扫描显示胰体尾部低密度，胰腺活检样本的组织病理学结果为胰腺导管腺癌伴区域淋巴结转移。我们回顾了他的既往病历，发现 20 个月前他开始接受利拉鲁肽治疗以降低血糖。当时，肿瘤标志物和上腹部常规 CT 无明显异常。我们使用 Naranjo 药物不良反应概率量表和世界卫生组织-乌普萨拉监测中心（WHO-UMC）系统评估了利拉鲁肽与胰腺癌之间的因果关系，结果表明因果关系可能存在。
我们的报告表明，利拉鲁肽可能与胰腺癌的发生和发展有关，并强调了对接受利拉鲁肽治疗的糖尿病患者进行定期检查的重要性。然而，我们的报告存在一些显著的局限性，未来需要进行更长时间、更大样本的随访试验，以评估利拉鲁肽与胰腺癌之间的因果关系。
