{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T22:44:28Z","timestamp":1777934668007,"version":"3.51.4"},"reference-count":39,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2025,6,11]],"date-time":"2025-06-11T00:00:00Z","timestamp":1749600000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Oncol Pharm Pract"],"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Immune checkpoint inhibitors (ICIs) are widely utilized in treating various malignancies but are associated with immune-related adverse events (irAEs), which often poses challenges to their use. Pancreatic irAEs, though rare, can present as new-onset diabetes, pancreatitis, or asymptomatic lipase elevation, often altering the clinical trajectory and quality of life of patients. This study sought to expand the understanding of this rare toxicity by summarizing the characteristics and outcomes of low-grade and high-grade pancreatic irAEs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a single-center, retrospective study of adult patients treated with checkpoint inhibitors between 2010 and 2022. Patients with clinical or radiographic evidence of pancreatic injury associated with ICI therapy were included. Pancreatic irAEs were defined as low-grade (&lt; grade 3) or high-grade (\u2265 grade 3) using the Common Terminology Criteria for Adverse Events.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Of 21 patients identified with pancreatic irAEs, 76% (n\u2009=\u200916) experienced high-grade severity, often requiring hospitalization. The majority of patients presented with either new-onset diabetes (n\u2009=\u200911) or pancreatitis (n\u2009=\u200911). Most low-grade irAEs resolved, while the majority of high-grade events did not, particularly due to the lasting nature of insulin-dependent diabetes. ICI rechallenge was attempted in most cases, although conclusions regarding subsequent disease and survival outcomes are limited.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Pancreatic irAEs, though uncommon, often present at higher toxicity grades at onset and require substantial medical intervention, whether acutely in the hospital or longitudinally in the outpatient setting. Early identification and management remain critical, and ICI rechallenge appears to be feasible in select patients. Further research is required to better predict and manage severe pancreatic irAEs.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/10781552251348662","type":"journal-article","created":{"date-parts":[[2025,6,11]],"date-time":"2025-06-11T04:02:31Z","timestamp":1749614551000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Characteristics and outcomes of low-grade and high-grade pancreatic immune-related adverse events at a single center"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0538-5443","authenticated-orcid":false,"given":"Reema","family":"Patel","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, Division of Hematology-Oncology, University of Virginia, Charlottesville, Virginia, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zakary","family":"Kolkey","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Hospital of the University of Pennsylvania, Philadelphia, PA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joslyn","family":"Jung","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Division of Hematology-Oncology, University of Virginia, Charlottesville, Virginia, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0786-8035","authenticated-orcid":false,"given":"Omar","family":"Elghawy","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Hospital of the University of Pennsylvania, Philadelphia, PA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-6360-3349","authenticated-orcid":false,"given":"Abhishek","family":"Mullapudi","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Division of Hematology-Oncology, University of Virginia, Charlottesville, Virginia, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jessica","family":"Xu","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Hospital of the University of Pennsylvania, Philadelphia, PA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Varinder","family":"Kaur","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Division of Hematology-Oncology, University of Virginia, Charlottesville, Virginia, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2025,6,11]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaci.2018.02.042"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(21)01206-X"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.3390\/jcm12134301"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.intimp.2022.108848"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ctrv.2024.102751"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1080\/14740338.2021.1867100"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.chest.2018.08.1048"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2017.77.6385"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00535-024-02083-1"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2023.1166299"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1093\/oncolo\/oyad150"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1097\/CJI.0000000000000472"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1002\/jgh3.12875"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1159\/000519588"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.3389\/fonc.2021.627612"},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.1186\/s40425-019-0502-7"},{"key":"e_1_3_2_18_2","doi-asserted-by":"publisher","DOI":"10.1136\/gutjnl-2012-302779"},{"key":"e_1_3_2_19_2","unstructured":"Common Terminology Criteria for Adverse Events [Internet]. https:\/\/ctep.cancer.gov\/protocolDevelopment\/electronic_applications\/ctc.htm#ctc_50."},{"key":"e_1_3_2_20_2","doi-asserted-by":"publisher","DOI":"10.3389\/fphar.2022.817662"},{"key":"e_1_3_2_21_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41416-024-02887-1"},{"key":"e_1_3_2_22_2","first-page":"587","article-title":"Incidence of pancreatitis with the use of immune checkpoint inhibitors (ICI) in advanced cancers: a systematic review and meta-analysis","volume":"19","author":"George J","unstructured":"George J, Bajaj D, Sankaramangalam K, et al. Incidence of pancreatitis with the use of immune checkpoint inhibitors (ICI) in advanced cancers: a systematic review and meta-analysis. Pancreatol Off J Int Assoc Pancreatol IAP Al 2019 Jun; 19: 587\u2013594.","journal-title":"Pancreatol Off J Int Assoc Pancreatol IAP Al"},{"key":"e_1_3_2_23_2","doi-asserted-by":"publisher","DOI":"10.1146\/annurev-pathol-042020-042741"},{"key":"e_1_3_2_24_2","doi-asserted-by":"publisher","DOI":"10.1155\/2018\/1027323"},{"key":"e_1_3_2_25_2","doi-asserted-by":"publisher","DOI":"10.1097\/CMR.0000000000000611"},{"key":"e_1_3_2_26_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00262-018-2178-0"},{"key":"e_1_3_2_27_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.alit.2022.01.001"},{"key":"e_1_3_2_28_2","doi-asserted-by":"publisher","DOI":"10.1097\/CJI.0000000000000202"},{"key":"e_1_3_2_29_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejca.2021.02.017"},{"key":"e_1_3_2_30_2","doi-asserted-by":"publisher","DOI":"10.1111\/hpb.12277"},{"key":"e_1_3_2_31_2","unstructured":"National Comprehensive Cancer Network. NCCN Clinical Practice Guidelines in Oncology: Management of immunotherapy-related toxicities (Version 1.2024) [Internet] https:\/\/www.nccn.org\/guidelines\/guidelines-detail?category=1&id=1478 (2024)."},{"key":"e_1_3_2_32_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.biopha.2022.113839"},{"key":"e_1_3_2_33_2","doi-asserted-by":"publisher","DOI":"10.1210\/clinem\/dgad685"},{"key":"e_1_3_2_34_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13098-024-01263-6"},{"key":"e_1_3_2_35_2","doi-asserted-by":"publisher","DOI":"10.2337\/dc21-2213"},{"key":"e_1_3_2_36_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoncol.2024.3104"},{"key":"e_1_3_2_37_2","doi-asserted-by":"publisher","DOI":"10.3389\/fphar.2022.955701"},{"key":"e_1_3_2_38_2","doi-asserted-by":"publisher","DOI":"10.3389\/fendo.2022.886930"},{"key":"e_1_3_2_39_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-022-11128-5"},{"key":"e_1_3_2_40_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41698-023-00380-1"}],"container-title":["Journal of Oncology Pharmacy Practice"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/10781552251348662","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/10781552251348662","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/10781552251348662","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,2]],"date-time":"2026-05-02T02:31:17Z","timestamp":1777689077000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/10781552251348662"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,6,11]]},"references-count":39,"alternative-id":["10.1177\/10781552251348662"],"URL":"https:\/\/doi.org\/10.1177\/10781552251348662","relation":{},"ISSN":["1078-1552","1477-092X"],"issn-type":[{"value":"1078-1552","type":"print"},{"value":"1477-092X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,6,11]]},"article-number":"10781552251348662"}}