Clinical Scorecard: Diabetes Mellitus Induced by Immune Checkpoint Inhibitors in Patients with Metastatic NSCLC: A Case Study with Long-term Follow-up and Management Insights

At a Glance

Key Highlights

• ICI-DM is a rare but severe endocrine immune-related adverse event.
• Characterized by rapid and often irreversible insulin deficiency.
• Frequent presentation with diabetic ketoacidosis (DKA).
• Lung cancer patients account for 20-30% of reported ICI-DM cases.
• Long-term management requires individualized therapeutic decisions.

Guideline-Based Recommendations

Diagnosis

• Early recognition of ICI-DM is essential to prevent complications.

Management

• Individualized management strategies based on multidisciplinary collaboration.

Monitoring & Follow-up

• Close monitoring of metabolic status and insulin requirements.

Risks

• Potential for life-threatening complications if not managed appropriately.

Patient & Prescribing Data

Elderly patients with metastatic lung adenocarcinoma treated with pembrolizumab.

Permanent insulin therapy may be required following ICI-DM onset.

Clinical Best Practices

• Multidisciplinary approach to manage ICI-DM.
• Consideration of patient-specific factors in treatment decisions.

Related Resources & Content

• KEYNOTE-024 trial
• KEYNOTE-189 trial
• KEYNOTE-407 trial