Open AccessEnd‐of‐life impact of concurrent diabetes mellitus and adrenal insufficiency as immune‐related adverse events in an advanced non‐small cell lung cancer patient
Author(s) -
Nakamura Tomoaki,
Takeyasu Yuki,
Yoshida Tatsuya,
Ohashi Ken,
Ohe Yuichiro
Publication year - 2022
Publication title -
thoracic cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.823
H-Index - 28
eISSN - 1759-7714
pISSN - 1759-7706
DOI - 10.1111/1759-7714.14660
Subject(s) - medicine , nivolumab , adverse effect , adrenal insufficiency , ipilimumab , diabetes mellitus , diabetic ketoacidosis , immune system , quality of life (healthcare) , insulin , endocrine system , cancer , oncology , immunotherapy , endocrinology , hormone , immunology , nursing
A 49‐year‐old man diagnosed with metastatic non‐small cell lung cancer was treated with immune checkpoint inhibitor (ICI) combination therapy (nivolumab + ipilimumab) as first‐line therapy. During the treatment course, the patient developed ICI‐associated diabetes mellitus and adrenal insufficiency, and insulin and hydrocortisone replacement therapy (10 mg/day) were initiated for endocrine toxicity. Despite systemic treatment, the disease progressed. Near the end of the patient's life, he was repeatedly hospitalized for diabetic ketoacidosis and adrenal crisis because he could not physically administer insulin subcutaneously or self‐administer oral hydrocortisone due to the deterioration of his general condition as a result of disease progression. This case report demonstrates that it is necessary to evaluate not only the impact of immune‐related adverse events on short‐term quality of life during ICI treatment but also on the patient's end‐of‐life care.