Table 1.
Clinical and biochemical data at diabetes onset in our index cases and cases reported in the literature
| Case n° 1 | Case n° 2 | Changizzadeh et al. [9] | Gunawan et al. [10] | Lowe et al. [11] | |
|---|---|---|---|---|---|
| Age (years) / Gender | 60/M | 80/F | 42/M | 52/M | 54/M |
| History of diabetes | T2DM | No | No | No | No |
| Familial history of diabetes | No | No | No | NR | NR |
| Neoplasia | Melanoma stage IV | Melanoma stage IV | Melanoma stage IV | Melanoma stage IV | Melanoma stage IV |
| Prior corticosteroid administration | No | No | No | Yesa | Yesb |
| ICI regimen | IPI (3 mg/kg) and NIVO (1 mg/kg) every 3 weeks | IPI (3 mg/kg) and NIVO (1 mg/kg) every 3 weeks | IPI (3 mg/kg) and NIVO (1 mg/kg) every 3 weeks | IPI (3 mg/kg) and NIVO (1 mg/kg) every 3 weeks | IPI (3 mg/kg) and NIVO (1 mg/kg) every 3 weeks |
| Time to T1DM onset | 2 weeks (1 cycle) | 5 weeks (1 cycle) | 12 weeks (3 cycles) | 11 weeks (3 cycles) | 19 weeks (3 cycles) |
| DKA | Yes | Yes | Yes | No | Yes |
| Plasma glucose (mmol/L) | 46 | 48.4 | 40.4 | 20.8 | NR |
| Ketones bodies (mmol/L) | |||||
| Plasma | NA | NA | NR | 2.4 | NR |
| Urine | > 7.8 | > 7.8 | NR | NR | 0.40 |
| HbA1C (%) | 7.5 | NA | 6.5 | 7.7 | NR |
| C-Peptide (nmol/L) | NA | NA | NR | 0.05 (N: 0.4–1.5) | NR |
| T1DM-related autoantibodies | + (GADA, ICA, IA2) | + (GADA, ICA) IA2 - | - (GADA, IA2, ZnT8A) | - (GADA, IA2, ZnT8A) | (GADA) |
| Other immune-related endocrine toxicities | None | Autoimmune thyroiditis | None | Hypophysitis, Diabetes insipidus | Autoimmune thyroiditis Hypophysitis |
| Non endocrine immune related toxicities | Presumed immune-checkpoint inhibitor-induced pancreatic injury | None | Colitis | None | Hepatitis, Colitis |
| Definitive discontinuation of ICI | Yes | Yes | Yes | Yes | Yes |
aIndication: autoimmune hypophysitis; Dexamethasone 8 mg twice a day for 24 h and then hydrocortisone 30 mg/day were started five weeks before T1DM onset. bIndication: autoimmune hepatitis and colitis; Prednisone was started ten weeks before T1DM and discontinued before T1DM onset. Abbreviations: M Male, F Female, ICI Immune checkpoint inhibitors, IPI Ipilimumab, NIVO Nivolumab, W Week; T2DM Type 2 diabetes mellitus, T1DM Type 1 diabetes mellitus, NA Not analysed, NR Not reported