Published online May 24, 2024. doi: 10.5306/wjco.v15.i5.576
Revised: February 25, 2024
Accepted: April 8, 2024
Published online: May 24, 2024
Processing time: 172 Days and 22.2 Hours
Immune checkpoint inhibitors (and more specifically programmed cell death 1/programmed cell death ligand 1 inhibitors as Pembrolizumab) initiated a revolution in the field of melanoma and have now expanded to several tumor subtypes and in increasingly broader clinical contexts, including the adjuvant and neoadjuvant setting, with potentially curable patients and prolonged survival. The side effects related to these drugs include a wide spectrum of manifestations, with endocrinological adverse events being some of the most frequent. Pembrolizumab-induced type 1 diabetes mellitus is an infrequent but potentially serious and not clearly reversible side effect that possesses characteristic clinical features and has high morbidity and mortality, with a chronic impact on quality of life. The etiopathogenesis of this phenomenom needs to be further investigated and a collaborative effort through the involvement of oncologists and other medical specialists is necessary for the correct identification and management of patients at risk.
Core Tip: Pembrolizumab-induced type 1 diabetes mellitus is a rare and potentially serious adverse event of immunotherapy, with a significant number of cases debuting abruptly and in a state of diabetic ketoacidosis without clear predisposing factors. Further research and strict follow-up by oncologists are fundamental tools for prevention and early treatment focusing on reducing the morbidity and mortality associated with this side effect.