Cancer Immunology, Immunotherapy

, Volume 65, Issue 6, pp 765–767 | Cite as

A case report of insulin-dependent diabetes as immune-related toxicity of pembrolizumab: presentation, management and outcome

  • Elizabeth HansenEmail author
  • Deepak Sahasrabudhe
  • Lynn Sievert
Letter to the Editors

Dear Editors,

The article entitled “Anti-programmed cell death-1 therapy and insulin-dependent diabetes: a case report” provided an interesting perspective on the onset of insulin-dependent diabetes following anti-programmed cell death therapy [1]. While several recent reports cite the incidence of diabetes onset, little is mentioned on outcome or clinical course over time. Here we present a case of pembrolizumab-induced insulin-dependent diabetes, with insight on the clinical outcome following discontinuation of the offending agent.

Here we present a 58-year-old male, diagnosed with a 2.1-mm thick, Clark Level IV, non-ulcerated, cutaneous melanoma of the left upper arm in 2000. He underwent a wide excision and left axillary lymph node sampling, which revealed one of three lymph nodes to be involved. He was treated with interferon alpha 2B as adjuvant therapy for 1 year. In 2012, imaging revealed a right upper lobe lung nodule, left upper paramediastinal mass and lymphadenopathy in...


Ipilimumab Vemurafenib Dabrafenib Axillary Lymph Node Sampling Harbor BRAF V600E 
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Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.


  1. 1.
    Martin-Liberal J, Furness AJ, Joshi K, Peggs KS, Quezada SA, Larkin J (2015) Anti-programmed cell death-1 therapy and insulin-dependent diabetes: a case report. Cancer Immunol Immunother 64(6):765–767. doi: 10.1007/s00262-015-1689-1 CrossRefPubMedGoogle Scholar
  2. 2.
    Mekinist (trametinib) [package insert]. East Hanover, NJ: Novartis Pharmaceuticals Corporation (2015)   Google Scholar
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    Tafinlar (dabrafenib) [package insert]. East Hanover, NJ: Novartis Pharmaceuticals Corporation (2015)Google Scholar
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    Pembrolizumab (keytruda) [package insert]. Whitehouse Station, NJ: Merk & Co., Inc. (2015)Google Scholar
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    Keytruda (pembrolizumab) [package insert]. Merck & Co., Inc., Whitehouse Station, NJ (2014)Google Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2016

Authors and Affiliations

  • Elizabeth Hansen
    • 1
    Email author
  • Deepak Sahasrabudhe
    • 1
  • Lynn Sievert
    • 1
  1. 1.University of Rochester Medical CenterRochesterUSA

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