Cancer Immunology, Immunotherapy

, Volume 66, Issue 1, pp 25–32 | Cite as

A case of pembrolizumab-induced type-1 diabetes mellitus and discussion of immune checkpoint inhibitor-induced type 1 diabetes

  • Young Kwang ChaeEmail author
  • Lauren Chiec
  • Nisha Mohindra
  • Ryan Gentzler
  • Jyoti Patel
  • Francis Giles
Original Article


Immune checkpoint inhibitors such as pembrolizumab, ipilimumab, and nivolumab, now FDA-approved for use in treating several types of cancer, have been associated with immune-related adverse effects. Specifically, the antibodies targeting the programmed-cell death-1 immune checkpoint, pembrolizumab and nivolumab, have been rarely reported to induce the development of type 1 diabetes mellitus. Here we describe a case of a patient who developed antibody-positive type 1 diabetes mellitus following treatment with pembrolizumab in combination with systemic chemotherapy for metastatic adenocarcinoma of the lung. We will also provide a brief literature review of other rarely reported cases of type 1 diabetes presenting after treatment with pembrolizumab and nivolumab, as well as discussion regarding potential mechanisms of this adverse effect and its importance as these drugs continue to become even more widespread.


Pembrolizumab Nivolumab Ipilimumab Diabetes mellitus Immunomodulatory Immune-related adverse effect 



Anaplastic lymphoma kinase




Computed tomography


Diabetic ketoacidosis


Epidermal growth factor receptor


Glutamic acid decarboxylase


Hemoglobin A1c


Islet antigen


Islet cell autoantigen


Kirsten rat sarcoma


Non-obese diabetic


Not reported


Non-small cell lung cancer


Paired box gene


Renal cell carcinoma


Small cell lung cancer


Type 1 diabetes mellitus


Regulatory T cell


Thyroid transcription factor




Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.


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Copyright information

© Springer-Verlag Berlin Heidelberg 2016

Authors and Affiliations

  • Young Kwang Chae
    • 1
    • 2
    • 3
    Email author
  • Lauren Chiec
    • 3
  • Nisha Mohindra
    • 1
    • 2
    • 3
  • Ryan Gentzler
    • 4
  • Jyoti Patel
    • 2
    • 3
    • 5
  • Francis Giles
    • 1
    • 2
    • 3
  1. 1.Developmental Therapeutics Program of the Division of Hematology/OncologyNorthwestern UniversityChicagoUSA
  2. 2.Robert H. Lurie Comprehensive Cancer Center of Northwestern UniversityChicagoUSA
  3. 3.Feinberg School of MedicineNorthwestern UniversityChicagoUSA
  4. 4.University of Virginia School of MedicineCharlottesvilleUSA
  5. 5.The University of Chicago MedicineChicagoUSA

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