Immunotherapy-Related Diabetes in Melanoma: A Management Perspective

EP: 1.An Overview of the Landscape Surrounding Melanoma

EP: 2.The Role of Biomarker Testing in Melanoma

EP: 3.The Current Landscape Surrounding Adjuvant Therapy in Melanoma

EP: 4.Combination Immunotherapy Strategies for Melanoma in the Adjuvant Setting

EP: 5.Navigating Challenges in Predicting and Mitigating Adverse Events in Adjuvant Immunotherapy

EP: 6.Exploring Immunotherapy Resistance: Impact on Treatment Decisions in Melanoma

EP: 7.Balancing Quality of Life: Adjuvant Therapy Toxicity in Melanoma Adjuvant Immunotherapy

EP: 8.Case 1: Man Aged 55 Years With Stage IIIB Melanoma Developing Immunotherapy-Induced Diabetes

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EP: 9.Immunotherapy-Related Diabetes in Melanoma: A Management Perspective

EP: 10.Immunotherapy-Induced Adrenal Insufficiency in Melanoma: Surveillance and Management

EP: 11.Case 2: 63-Year-Old Female Patient With Metastatic Melanoma on Dual Immunotherapy Developing Treatment-Related Myocarditis

EP: 12.Approaches to Diagnosing and Managing Myocarditis Related to Immunotherapy

EP: 13.Expert Perspectives on Cardiac Baseline and Surveillance Testing in Immunotherapy Recipients

EP: 14.Corticosteroid Treatment Challenges in Patients with Immunotherapy-Related Toxicities

EP: 15.Forward Outlook and Clinical Insights in Melanoma Treatment

This is a video synopsis/summary of an OncLive Insights^® involving Afreen Shariff, MD, MBBS; Javid Moslehi, MD; and Nikhil Khushalani, MD.

Khushalani asks Shariff how often she consults endocrinology for immunotherapy-induced type 1 diabetes (T1D) and when it should be done. She states T1D occurs in less than 1% of immunotherapy-treated patients, but she sees many cases. The key is recognizing abrupt hyperglycemia without recent steroids or type 2 diabetes history. Endocrinology should be urgently consulted to start insulin and avoid diabetic ketoacidosis given complete β-cell destruction.

Regarding additional management, studies are investigating agents such as teplizumab to salvage islet cells in early T1D. However, it remains unclear whether they will be approved for patients with cancer. Otherwise, endocrine toxicity should not preclude immunotherapy continuation with close monitoring/management.

For the presented patient with stage III disease, Shariff recommends resuming adjuvant therapy after diabetes optimization without holding treatment given lack of data that T1D increases other toxicity risks. Khushalani agrees this is typical practice at specialty centers, though community oncologists may admit patients before continuing immunotherapy.

Video synopsis is AI generated and reviewed by OncLive^® editorial staff.