Cadonilimab therapy in cervical cancer associated with new-onset type 1 diabetes and diabetic ketoacidosis in a case report.

A systematic review incorporating a case report describes an 81-year-old female patient diagnosed with cervical squamous cell carcinoma who had no prior history of diabetes mellitus. The patient received multiple cycles of cadonilimab, a dual-target immune checkpoint inhibitor. Following treatment, she developed diabetic ketoacidosis (DKA), which is classified as a serious immune-related adverse event. Subsequent management involved insulin therapy and fluid resuscitation, which effectively controlled her blood glucose levels.

The primary outcome of interest was the development of DKA, which occurred in this single case. Secondary outcomes included monitoring of blood glucose levels and a review of the epidemiology, pathogenesis, and clinical management strategies for immune checkpoint inhibitor-induced type 1 diabetes mellitus (ICI-T1DM). The case highlights the potential for endocrine toxicity associated with this specific class of medications.

Safety considerations indicate that DKA was a serious adverse event observed in this instance. The review aims to enhance clinician awareness of ICI-T1DM, particularly regarding the endocrine toxicity of dual-target ICIs like cadonilimab. However, the study design is limited by the inclusion of only one case, which restricts the ability to determine incidence rates or establish definitive causal relationships. No specific limitations were reported in the source data regarding study methodology or funding conflicts.

The practice relevance of this finding is to provide a practical reference for ensuring safety in cancer patients receiving ICI therapy. Clinicians should recognize that while rare, new-onset type 1 diabetes and DKA can occur during treatment. Further research is needed to clarify the frequency of these events and optimize management strategies for affected patients.