Immune checkpoint inhibitor-related type 1 diabetes mellitus which develops long after treatment discontinuation: a case report and review of literature

Obata, Yoshinari; Takemoto, Miho; Sakaue, Taka-Aki; Kawata, Satoshi; Mukai, Kosuke; Miyashita, Kazuyuki; Kozawa, Junji; Nishizawa, Hitoshi; Shimomura, Iichiro

doi:https://doi.org/10.1007/s13340-024-00719-4

Immune checkpoint inhibitor-related type 1 diabetes mellitus which develops long after treatment discontinuation: a case report and review of literature

Obata, Yoshinari; Takemoto, Miho; Sakaue, Taka-Aki et al.

Diabetology International, 2024, 15(3), 605-610

Number of Access:948（2025-07-18 09:54 Counts）

Identifier to cite or link to this item: https://hdl.handle.net/11094/100237

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Title	Immune checkpoint inhibitor-related type 1 diabetes mellitus which develops long after treatment discontinuation: a case report and review of literature
Creator	ORCID 0000-0002-3443-3635 0000-0002-3443-3635 researchmap permalink osaka-u-obata osaka-u-obata CreatorName Obata, Yoshinari
	CreatorName Takemoto, Miho
	CreatorName Sakaue, Taka-Aki
	researchmap permalink osaka-endmet-kawata osaka-endmet-kawata CreatorName Kawata, Satoshi
	NRID 1000020815352 1000020815352 researchmap permalink mukai mukai Scopus Author ID 55045414800 55045414800 CreatorName Mukai, Kosuke
	NRID 1000010166168 1000010166168 researchmap permalink read0014367 read0014367 CreatorName Miyashita, Kazuyuki
	NRID 1000080513001 1000080513001 researchmap permalink jkkk jkkk Scopus Author ID 6506399971 6506399971 CreatorName Kozawa, Junji
	NRID 1000020379259 1000020379259 researchmap permalink Hitoshi_Nishizawa Hitoshi_Nishizawa Scopus Author ID 7102282682 7102282682 CreatorName Nishizawa, Hitoshi
	NRID 1000060346145 1000060346145 researchmap permalink shimomura_i shimomura_i Scopus Author ID 7006715546 7006715546 ORCID 0000-0002-0851-9603 0000-0002-0851-9603 CreatorName Shimomura, Iichiro
Subject	Atezolizumab
	Discontinuation
	Fulminant type 1 diabetes
	Immune checkpoint inhibitors
Description	This version of the article has been accepted for publication, after peer review (when applicable) and is subject to Springer Nature’s AM terms of use, but is not the Version of Record and does not reflect post-acceptance improvements, or any corrections. The Version of Record is available online at: https://doi.org/10.1007/s13340-024-00719-4.
Abstract	Immune checkpoint inhibitor (ICI)-related type 1 diabetes is an immune-related adverse event (irAE), occurring in slightly less than 1% of patients undergoing ICI therapy. Most cases develop during ICI treatment, with occurrences long after discontinuation being extremely rare. A 76-year-old woman, with no history of glucose tolerance issues, was diagnosed with lung adenocarcinoma with pleural invasion and underwent chemotherapy, including atezolizumab, an anti-programmed death-ligand 1 antibody. This treatment was discontinued due to disease progression, although she continued with other chemotherapy regimens. Approximately 5.5 months (166 days) after her last atezolizumab dose, she developed diabetic ketoacidosis, fulfilling the diagnostic criteria for fulminant type 1 diabetes. Anti-glutamic acid decarboxylase antibodies were positive. The patient carried susceptibility human leukocyte antigen (HLA) haplotypes, which are associated with type 1 diabetes. To date, including our patient, only nine cases of ICI-related type 1 diabetes developed after ICI discontinuation have been precisely reported. Eight cases originated from East Asia, with six exhibiting fulminant type 1 diabetes, and seven tested negative for islet-related autoantibodies. The reported cases were independent of ICI types, cycle number, or HLA haplotypes. Median time from the last ICI administration to diabetes onset was 4 months (range: 2–7 months). Although reports of cases occurring after ICI discontinuation are currently limited, their frequency may increase with the wider use of ICIs and improved survival rates of patients post-treatment. Therefore, it is crucial to remain vigilant for the development of ICI-related type 1 diabetes, not only during ICI administration, but also long after discontinuation.
Publisher	Springer
Source Title	Diabetology International
Volume (Issue)	15(3)
Page	605-610
Date of Issued	2024-07-01
Language	English
Handle URL	https://hdl.handle.net/11094/100237
PISSN	21901678
eISSN	21901686
Relation.isVersionOf	DOI (Publisher Version) https://doi.org/10.1007/s13340-024-00719-4
Access Rights	open access
oaire:version	Accepted Manuscript
Category	学術雑誌論文 Journal Article

Resource Type	journal article
Local Type	Journal Article
DCTERMS.bibliographicCitation	Diabetology International. 2024, 15(3), p. 605-610
DC.title	Immune checkpoint inhibitor-related type 1 diabetes mellitus which develops long after treatment discontinuation: a case report and review of literature
DC.creator	Obata, Yoshinari
	Takemoto, Miho
	Sakaue, Taka-Aki
	Kawata, Satoshi
	Mukai, Kosuke
	Miyashita, Kazuyuki
	Kozawa, Junji
	Nishizawa, Hitoshi
	Shimomura, Iichiro
DC.publisher	Springer
DC.language' scheme='DCTERMS.RFC1766	English
DCTERMS.issued' scheme='DCTERMS.W3CDTF	2024-07-01
DC.identifier	https://doi.org/10.1007/s13340-024-00719-4
DC.subject	Atezolizumab
	Discontinuation
	Fulminant type 1 diabetes
	Immune checkpoint inhibitors
DC.description	This version of the article has been accepted for publication, after peer review (when applicable) and is subject to Springer Nature’s AM terms of use, but is not the Version of Record and does not reflect post-acceptance improvements, or any corrections. The Version of Record is available online at: https://doi.org/10.1007/s13340-024-00719-4.
DCTERMS.abstract	Immune checkpoint inhibitor (ICI)-related type 1 diabetes is an immune-related adverse event (irAE), occurring in slightly less than 1% of patients undergoing ICI therapy. Most cases develop during ICI treatment, with occurrences long after discontinuation being extremely rare. A 76-year-old woman, with no history of glucose tolerance issues, was diagnosed with lung adenocarcinoma with pleural invasion and underwent chemotherapy, including atezolizumab, an anti-programmed death-ligand 1 antibody. This treatment was discontinued due to disease progression, although she continued with other chemotherapy regimens. Approximately 5.5 months (166 days) after her last atezolizumab dose, she developed diabetic ketoacidosis, fulfilling the diagnostic criteria for fulminant type 1 diabetes. Anti-glutamic acid decarboxylase antibodies were positive. The patient carried susceptibility human leukocyte antigen (HLA) haplotypes, which are associated with type 1 diabetes. To date, including our patient, only nine cases of ICI-related type 1 diabetes developed after ICI discontinuation have been precisely reported. Eight cases originated from East Asia, with six exhibiting fulminant type 1 diabetes, and seven tested negative for islet-related autoantibodies. The reported cases were independent of ICI types, cycle number, or HLA haplotypes. Median time from the last ICI administration to diabetes onset was 4 months (range: 2–7 months). Although reports of cases occurring after ICI discontinuation are currently limited, their frequency may increase with the wider use of ICIs and improved survival rates of patients post-treatment. Therefore, it is crucial to remain vigilant for the development of ICI-related type 1 diabetes, not only during ICI administration, but also long after discontinuation.
DC.format	100237
citation_title	Immune checkpoint inhibitor-related type 1 diabetes mellitus which develops long after treatment discontinuation: a case report and review of literature
citation_author	Obata, Yoshinari
	Takemoto, Miho
	Sakaue, Taka-Aki
	Kawata, Satoshi
	Mukai, Kosuke
	Miyashita, Kazuyuki
	Kozawa, Junji
	Nishizawa, Hitoshi
	Shimomura, Iichiro
citation_publisher	Springer
citation_language	English
citation_date	2024-07-01
citation_journal_title	Diabetology International
citation_volume	15
citation_issue	3
citation_firstpage	605
citation_lastpage	610
citation_doi	https://doi.org/10.1007/s13340-024-00719-4
citation_public_url	https://hdl.handle.net/11094/100237

Immune checkpoint inhibitor-related type 1 diabetes mellitus which develops long after treatment discontinuation: a case report and review of literature

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