Sintilimab-Induced Diabetic Ketoacidosis in a Patient with Radiation and Multichemorefractory Penile Cancer: A Case Report and Literature Review.

Penile squamous cell carcinoma (PSCC) is a rare disease. The treatment options for advanced penile cancer are often limited, and the prognosis remains poor. We reported a 52-year-old male recurrent and metastatic PSCC patient with high PD-L1 expression (90%) and TMB (14. 4 muts/Mb). He had undergone penectomy, bilateral inguinal lymph node dissection, and excision of the abdominal wall mass. Despite cisplatin-based concurrent chemoradiotherapy and sequential chemotherapy with docetaxel plus cisplatin then being carried out, the carcinoma still progressed. The patient then obtained progression-free survival with continuous sintilimab, although he experienced the new onset of ICI-induced diabetes after 24 cycles of sintilimab and required sustained insulin treatment. He had negative type 1 diabetes-associated autoantibodies and the susceptible HLA genotype DR3-DQ2 haplotype. This is the first patient with radiation and multichemorefractory PSCC who has obtained the remarkable anti-tumor effect of partial regression exceeding 32 months during continuous sintilimab and anlotinib treatment.

Current oncology (Toronto, Ont.). 2022 Oct 25*** epublish ***

Chuan Lv, Can Wu, Yan Zhang, Wendong Li, Xuesong Wang, Li Liang

Department of Endocrinology, People's Hospital of China Medical University, The People's Hospital of Liaoning Province, Shenyang 110016, China., Endoscopy Department, The First Affiliated Hospital of China Medical University, Shenyang 110001, China., Department of Ophthalmology, Shenyang Tenth People's Hospital, Shenyang 110044, China., Radiology Department, People's Hospital of China Medical University, Shenyang 110016, China., Department of Urology, People's Hospital of China Medical University, Shenyang 110016, China.