Association of diabetes mellitus with efficacy of first-line pembrolizumab for metastatic non-small cell lung cancer

Diabetes mellitus (DM) is a prevalent chronic metabolic disorder, associated with immune dysfunction. A retrospective study in Israel investigated the association of DM with efficacy of first-line pembrolizumab for metastatic non-small cell lung cancer (mNSCLC). Among 203 eligible patients, 51 (25%) had DM. Patients with DM had significantly shorter mPFS and mOS compared with patients without DM. The shorter OS in DM patients was more pronounced when pembrolizumab was given alone than when combined with chemotherapy. In a validation cohort of 452 mNSCLC patients, the time on pembrolizumab treatment was shorter among DM patients (p=0.025), with only 19.6% of patients remaining on treatment at 12 months compared with 31.7% of non-DM patients. The authors conclude that pembrolizumab is less beneficial in diabetic mNSCLC patients.