Recent advances in immune checkpoint inhibitor-induced type 1 diabetes mellitus

• Published in: International immunopharmacology 2023-09, Vol.122, p.110414-110414, Article 110414
• Main Authors: Liao, Dehua, Liu, Chaoyi, Chen, Shanshan, Liu, Fen, Li, Wei, Shangguan, Dangang, Shi, Yingrui
• Format: Article
• Language: English
• Subjects: Endocrine toxicity; Immune checkpoint inhibitors; irAEs; Type 1 diabetes mellitus
• ISSN: 1567-5769; 1878-1705
• DOI: 10.1016/j.intimp.2023.110414

•Immune-related adverse events affect multiple organs.•ICIs-induced Type 1 diabetes mellitus is an important endocrine toxicity.•The management of ICIs-induced T1DM is essential for ICIs in clinical practice. As a new group of anticancer drugs, immune checkpoint inhibitors (ICIs) have exhibited favorable antitumor efficacy in numerous malignant tumors. Anti-cytotoxic T lymphocyte associated antigen-4 (CTLA-4), anti-programmed cell death-1 (PD-1) and anti-programmed cell death ligand-1 (PD-L1) are three kinds of ICIs widely used in clinical practice. However, ICI therapy (monotherapy or combination therapy) is always accompanied by a unique toxicity profile known as immune-related adverse events (irAEs) affecting multiple organs. The endocrine glands are common targets of irAEs induced by ICIs, which cause type 1 diabetes mellitus (T1DM) when the pancreas is affected. Although the incidence rate of ICI-induced T1DM is rare, it will always lead to an irreversible impairment of β-cells and be potentially life-threatening. Hence, it is vital for endocrinologists and oncologists to obtain a comprehensive understanding of ICI-induced T1DM and its management. In our present manuscript, we have reviewed the epidemiology, pathology and mechanism, diagnosis, management, and treatments of ICI-induced T1DM.