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Until now, only about 1% of patients on immunotherapy seem to develop diabetes, but as relatively new treatment becomes more common, drug-related diabetes could also be.
Although glucose and insulin injections are controlled with care, diabetes can be life threatening, not to mention the quality of life of patients.
Scientists, including the Parker Institute for Cancer Immunotherapy, are scrambling to identify how this phenomenon occurs and why it happens to some patients but not to others.
Immunotherapy effectively strengthens the immune system by disabling natural proteins that prevent immune cells from fighting cancer from multiplying and attacking tumor cells with full force.
But the immune system is a complex and delicately balanced set of processes, cells and organs.
Perhaps unsurprisingly, tinkering with part of it can have vast implications for other parties.
Since the approval of the first modern immunotherapy in 1997, doctors have reported an increasing number of side effects related to the immune system, including diabetes and even death.
The researchers believe that these autoimmune problems result from the fact that the treatment disrupts the immune system, making it think that its cells useful for fighting infections are foreign bodies and attack them.
Autoimmune disease, independent of immunotherapy, diabetes develops when the immune system begins to attack the beta cells that produce insulin and allows the body to properly break down glucose and convert it into energy.
So while immuno-oncologists want to strengthen the immune system to fight cancer of their own cells – which went wrong – by turning off T-cell blockers, they do not want it to touch B-cells.
Patients who end up with life-altering diabetes are less likely to continue their immunotherapy treatments. Therefore, solving the problem of diabetes is also about ensuring that the treatment produces the best results for most people.
For some reason, those who have no previous disease, but develop diabetes related to immunotherapy, seem to have some forms of the disease that involve dramatic fluctuations in blood sugar dangerously high at an extremely low blood sugar.
These patients will never again produce their own healthy insulin, at least not enough to keep them healthy.
To alleviate this, patients must take insulin injections consistently for the rest of their lives.
Beyond the fact that immunotherapy seems to be able to turn the immune system against itself, scientists are not sure of the genetic, environmental or other factors involved in successful treatment.
Backed by Sean Parker, the infamous and infamous entrepreneur of Napster and Facebook, a group of specialists is investing $ 10 million to try to solve it.
They plan to spend three years evaluating patients and the pathways through which diabetes develops.
"The clinical success of immune checkpoint inhibitors such as ipilimumab, nivolumab and pembrolizumab has changed the way cancer treatment is done, extending the lives of patients who previously had little of choice, "said Dr. Jeffrey Bluestone, CEO and President of the Parker Institute.
"In rare cases, these patients develop insulin-dependent diabetes, and no one really understands how and why."
He and his badociates hope their discoveries will not only help cancer patients, but anyone with type 1 diabetes.
"By investing in this research, we will be able to better understand, in real time, how Type 1 diabetes develops and can potentially weaken the immune system, so that disease progression never occurs," said Dr. Aaron Kowalks, President and CEO of JDRF.
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