Clinical history and key laboratory findings

Age/sexPrimary DiagnosisMedical HistoryHistory FamilyAnti-PD1 DrugOther chemo-toxinsDiabetes presentationRandom C-peptide and BGTime After PD-1Ab titers before nivolumab*Ab titers after nivolumabHLA
34/FNSCLCNoneNo history of DMNivolumabCarboplatin, pemetrexedDKA, BG 739, HbA1C 7.1%, urine ketones >80 mg/dL<0.1 ng/mL while BG 377 mg/dL2 wks+ GAD65 (> 250), + IA-2 (6.2), - IAA (< 0.4), + ZnT8 (64)+ GAD65 (> 30)a, + IA-2 (6.1), + IAA (0.4), - ZnT8 (13)bA30:01,30:02 (A30) D09:CTZ,09:CTZ (DR9)

Diabetic autoantibodies to GAD65, IA-2, and Insulin Ab were performed at Quest Diagnostics, San Juan Capistrano. Normal GAD65 titers < 0.5 IU/mL, IA-2 Ab < 0.8 U/mL, IAA < 0.4U/mL, and ZnT8 Ab <15 U/mL

*Diabetic autoantibody testing before treatment was performed using a stored frozen specimen obtained at time of lung cancer diagnosis, 8 months prior to Nivolumab treatment

aQuest changed GAD65 assay type from RIA to ELISA between the time the before and after treatment specimens were processed

bZnT8 Ab obtained 13 months after the onset of diabetes