Immune-Mediated Diabetes Induced by Dostarlimab: A Case Report

Area of Science:

• Oncology
• Immunology
• Endocrinology

Background:

• Immune checkpoint inhibitors (ICIs) targeting PD-1/PD-L1 are crucial in cancer therapy.
• ICI-related immune-mediated adverse events are known, but diabetes is rare.
• Dostarlimab is a PD-1 inhibitor used for endometrial cancer.

Purpose of the Study:

• To report the first case of immune-mediated diabetes mellitus induced by dostarlimab.
• To highlight the clinical presentation and management of this rare adverse event.

Main Methods:

• Case report of a 78-year-old woman with endometrial adenocarcinoma.
• Administration of six cycles of dostarlimab.
• Clinical assessment for diabetic ketoacidosis, HbA1c, C-peptide, and autoimmune antibodies.

Main Results:

• The patient developed diabetic ketoacidosis after dostarlimab treatment.
• Autoimmune antibodies were negative, but clinical presentation suggested ICI-induced diabetes.
• Discontinuation of dostarlimab led to resolution of peritoneal disease.

Conclusions:

• Dostarlimab can induce immune-mediated diabetes mellitus, a rare but significant adverse event.
• Early recognition and management are crucial for patients receiving dostarlimab.
• This case underscores the importance of monitoring for endocrine toxicities with ICIs.