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ORIGINAL RESEARCH article

Front. Endocrinol.
Sec. Cancer Endocrinology
Volume 15 - 2024 | doi: 10.3389/fendo.2024.1439705

HOMA-beta independently predicts survival in patients with advanced cancer on treatment with immune checkpoint inhibitors

Provisionally accepted
Mayu Watanabe Mayu Watanabe 1,2*JUN EGUCHI JUN EGUCHI 1,3*Atsushi Takamoto Atsushi Takamoto 4Hiromitsu Kanzaki Hiromitsu Kanzaki 5Yohei Noda Yohei Noda 4Syunsuke Kagawa Syunsuke Kagawa 1,6Jun Wada Jun Wada 1
  • 1 Graduate School of Medicine Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Okayama, Japan
  • 2 National Hospital Organization Okayama Medical Center, Okayama, Okayama, Japan
  • 3 Okayama University, Okayama, Japan
  • 4 Fukuyama City Hospital, Fukuyama, Hiroshima, Japan
  • 5 Tsuyama Chuo Hospital, Tsuyama, Okayama, Japan
  • 6 Okayama University Hospital, Okayama University, Okayama, Okayama, Japan

The final, formatted version of the article will be published soon.

    Although immune checkpoint inhibitors (ICIs) are effective cancer drugs, ICI-induced diabetes is a rare but a life-threatening adverse event for patients. The deleterious action of ICI on pancreatic betacell function is a concern. However, the influence of ICI on insulin synthesis and secretion in patients with cancer without diabetes remains unknown.This study included 87 patients diagnosed with advanced cancer. Glucose metabolism markers (HbA1c, HOMA-IR) and indicators of insulin secretory capacity (HOMA-beta, C-peptide) were prospectively evaluated in patients with ICI-treated cancers to determine their association with cancer prognosis.Patients with overall survival (OS) ≥ 7 months had substantially higher HOMA-beta levels at baseline (p=0.008) and 1 month after ICI administration (p=0.006) compared to those with OS <7 months. The median OS was significantly longer in patients with 37 events) than in those with HOMA-beta < 64.24 (5 months, 95%CI: 3.280-6.720, 50 events) (p=0.013). Further, the median progression-free survival (PFS) was significantly longer in patients with HOMA-beta ≥ 66.43 (4 months, 95%CI: 3.073-4.927, 33 events) than in those with HOMA-beta < 66.43 (2 months, 95%CI: 1.410-2.590, 54 events) (p=0.025). Additionally, multivariable logistic regression analysis revealed that a HOMA-beta value ≥ 64.24 independently predicted longer OS in ICI-treated patients.

    Keywords: anti-PD1 immune checkpoint inhibitors, insulin secretory capacity, Cancer prognosis, insulin secretion, Glucose metabolism markers

    Received: 28 May 2024; Accepted: 25 Nov 2024.

    Copyright: © 2024 Watanabe, EGUCHI, Takamoto, Kanzaki, Noda, Kagawa and Wada. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence:
    Mayu Watanabe, Graduate School of Medicine Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, 700 - 8558, Okayama, Japan
    JUN EGUCHI, Okayama University, Okayama, Japan

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