Powerful new cancer drugs are saving lives, but can also ignite diabetes or other autoimmune conditions
Last week, Yale University immunologist Kevan Herold spoke about a few of his newest diabetes patients to an unlikely audience: oncologists and cancer researchers. At the Society for Immunotherapy of Cancer’s annual meeting in Oxon Hill, Maryland, Herold and other speakers described how a novel class of promising cancer drugs is causing type 1 diabetes and other autoimmune diseases in some of those treated.
Known as checkpoint inhibitors, these medicines rev up the immune system and are rescuing people from deadly cancers. Physicians such as Herold, however, are now seeing a nasty, if treatable, side effect: the rapid onset of conditions such as thyroid disease, colitis, and type 1 diabetes, which all result from an immune attack on the body’s own tissues. As cases mount, researchers across specialties are intensifying efforts to figure out whether certain cancer patients on checkpoint inhibitors are at higher risk—and to learn from this unusual side effect how autoimmune attacks erupt. “These [patients] are human experiments” of the autoimmune process, Herold says.
The first case walked into Herold’s office a few years ago. She was 55 years old and had suddenly developed type 1 diabetes, which occurs when the body destroys cells in the pancreas that make insulin. Though the more common form of diabetes, type 2, is often diagnosed in middle age, type 1 is not. Herold learned that she had melanoma, and weeks earlier had received the checkpoint inhibitor nivolumab, an antibody that blocks the activity of a receptor called PD-1 on T cells.
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