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Analysis of Pembrolizumab-induced Blood Glucose Level Change in Cancer Patients

암환자에서 Pembrolizumab 투여로 인한 혈당수치 변화 분석

  • Jung, Hee Yoon (College of Pharmacy, Chungnam National University) ;
  • Hong, Min-Soo (College of Pharmacy, Chungnam National University) ;
  • Jung, Woo Jin (College of Pharmacy, Chungnam National University) ;
  • Choi, Sun Ok (College of Pharmacy, Chungnam National University) ;
  • Chae, Jung-woo (College of Pharmacy, Chungnam National University) ;
  • Yun, Hwi-yeol (College of Pharmacy, Chungnam National University)
  • Received : 2021.09.09
  • Accepted : 2021.09.19
  • Published : 2021.09.30

Abstract

Background: Pembrolizumab, an anti-cancer drug, is known to increase the activity of the immune system, leading to side effects called immune-related adverse events (irAE), including type 1 diabetes. This study analyzed the correlation between blood glucose level and pembrolizumab administration and investigated the covariates that affect those changes in cancer treatment. Methods: The information of 133 adult cancer patients was obtained from the electronic medical record (EMR) to identify the changes in random blood glucose (RBG) levels during the pembrolizumab treatment. Subjects were classified into subgroups according to their baseline RBG level, history of diabetes, and the use of steroids, and linear regression analysis was conducted. In addition, a secondary analysis was performed within the group of subjects having a strong correlation to glycemic change, which was based on the Pearson correlation coefficient being less than -0.7 or greater than +0.7. Univariate and multivariate logistic regressions were conducted to identify the risk factors to glycemic increase. Results: The RBG level tended to descend without significant differences in total patients during the administration period of pembrolizumab. Despite the insignificance, the logistic regression analysis presents that the odds ratios of baseline RBG less than 130 mg/dL, prophylactic steroid use, and higher dose of pembrolizumab per cycle (mg/kg/cycle) were greater than 1. Conclusions: Prophylactic administration of steroids and a higher dose of pembrolizumab per cycle may increase the blood glucose level as irAE in cancer patients with a strong tendency to glycemic change.

Keywords

Acknowledgement

이 논문은 충남대학교 학술연구비 및 2020년도 정부(과학기술정보통신부)의 재원으로 정보통신기획평가원(No. 2020-0-01441, 인공지능융합연구센터(충남대학교))의 지원을 받아 수행된 연구입니다.

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