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How would you advise medical oncologists who recommend checkpoint inhibitors for a patient with baseline type 1 diabetes?
Some oncologists may have concerns that checkpoint inhibitors could diminish islet cell reserve and lead to worsening DM control.
Answer from: at Community Practice
T1DM means near-complete beta-cell deficiency. These patients aren’t making enough insulin to impact blood glucose control. We always treat the cancer first, with the most appropriate medications, and worry about the diabetes later. We even advise oncologists to continue ICIs after a patient d...
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Answer from: at Community Practice
CPI therapy has been a tremendous advance in the treatment of malignancies, but it comes with multiple adverse endocrine events, including new-onset T1DM, which can be fulminant in onset, occurs in around 1% of patients, and is irreversible. Around 0.6% of patients with pre-existing T2DM noticed wor...
Answer from: at Community Practice
I agree with Dr. @Perlman and would add that in pre-existing T1DM, with autoimmune beta cell failure that is necessarily treated with exogenous insulin, the addition of a checkpoint inhibitor may or may not impact glycemia. Depending on the duration of T1DM and if there is any beta cell reserve, the...