ID | 118605 |
著者 |
Ichihara, Seiya
National Hospital Organization Kochi Hospital
國重, 道大
National Hospital Organization Kochi Hospital
Kadota, Naoki
National Hospital Organization Kochi Hospital
Okano, Yoshio
National Hospital Organization Kochi Hospital
Machida, Hisanori
National Hospital Organization Kochi Hospital
Hatakeyama, Nobuo
National Hospital Organization Kochi Hospital
Naruse, Keishi
National Hospital Organization Kochi Hospital
Takeuchi, Eiji
National Hospital Organization Kochi Hospital
|
キーワード | acute-onset type 1 diabetes
after discontinuation
immune-related adverse events
late-onset
non-small-cell lung cancer
|
資料タイプ |
学術雑誌論文
|
抄録 | Immune-related adverse events (irAEs) occur in rare cases, even after the completion of immune checkpoint inhibitor (ICI) therapy. We encountered a lung cancer patient diagnosed with acute-onset type 1 diabetes mellitus (DM) 7 months after the cessation of ICI. A 68-year old woman was referred to our hospital for chest abnormalities. She was diagnosed with lung adenocarcinoma cT4N2M1c, stage IVB. Immunostaining showed that the expression of programmed death ligand 1 in tumor cells was negative. A genetic analysis using the Oncomine Dx Target Test Multi-CDx System revealed that the primary tumor was positive for ERBB2. Combined immunotherapy with carboplatin, pemetrexed, and pembrolizumab was performed as first-line therapy, followed by maintenance therapy with pemetrexed plus pembrolizumab, which was successful. After the seventh course, maintenance therapy was stopped because only the primary tumor showed local enlargement. Local chest radiotherapy (66 Gy/33 Fr) was performed, and the patient was followed up. HbA1c was 4.9% 3 months after the completion of pembrolizumab, and dry mouth and polyuria occurred after 5 months. Seven months later, the patient developed diabetic ketoacidosis with a blood glucose of 348 mg/dL and an HbA1c of 11.3%. Antiglutamic acid decarboxylase antibodies were negative and urinary C-peptide was 9.3 μg/day. The patient was diagnosed with acute-onset type 1 diabetes and received insulin therapy. There has been no case report of type 1 diabetes diagnosed 7 months after the last administration of an ICI. These results indicate that irAE needs to be considered even after the cessation of ICI.
|
掲載誌名 |
Thoracic Cancer
|
ISSN | 17597714
17597706
|
出版者 | China Lung Oncology Group|John Wiley & Sons Australia
|
巻 | 14
|
号 | 1
|
開始ページ | 81
|
終了ページ | 84
|
発行日 | 2022-11-21
|
権利情報 | This is an open access article under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
|
EDB ID | |
出版社版DOI | |
出版社版URL | |
フルテキストファイル | |
言語 |
eng
|
著者版フラグ |
出版社版
|
部局 |
医学系
|