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2512002627
  • Open Access
  • Article

Effect of New Oncological Therapies on Glucose Metabolism

  • Marilda Mormando 1,   
  • Vittoria Strinati 2,   
  • Eleonora Ciocca 3,   
  • Marta Bianchini 1,   
  • Rosa Lauretta 1,   
  • Giulia Puliani 1,   
  • Marialuisa Appetecchia 1,*

Received: 26 Aug 2025 | Revised: 09 Nov 2025 | Accepted: 24 Dec 2025 | Published: 16 Jan 2026

Abstract

Targeted cancer therapies and immunotherapy significantly impact glucose metabolism. Tyrosine kinase inhibitors (TKIs) such as imatinib and dasatinib have demonstrated beneficial effects by improving glycemic control and preserving pancreatic β-cell function. However, glycemic outcomes vary among TKIs; for example, nilotinib has been associated with impaired glucose regulation, while multikinase inhibitors produce heterogeneous metabolic effects. In contrast, mTOR inhibitors (everolimus, temsirolimus) frequently induce hyperglycemia through complex disruptions of insulin signaling pathways and β-cell functionality. Immune checkpoint inhibitors (ICIs) enhance anti-tumor immune responses by blocking CTLA-4 and PD-1 pathways but can compromise immune tolerance, leading to immune-related adverse events (irAEs). Among these, ICI-induced diabetes mellitus (ICI-DM) is a rare yet severe autoimmune disorder characterized by rapid pancreatic β-cell destruction, often presenting as diabetic ketoacidosis. Unlike the predominantly insulin-resistant diabetes mellitus associated with TKIs and mTOR inhibitors, ICI-DM resembles insulin-dependent type 1 diabetes mellitus and necessitates urgent insulin therapy and vigilant glucose monitoring. Management strategies differ accordingly: TKIs and mTOR inhibitor-induced hyperglycemia are typically addressed with first-line oral agents such as metformin, while ICI-DM requires immediate initiation of insulin treatment. Early recognition and interdisciplinary collaboration with metabolic disorders specialists are critical to preventing severe metabolic complications and allowing continuation of oncologic therapies. Further investigation is warranted to elucidate the precise molecular mechanisms driving these glucose metabolism disturbances and to optimize therapeutic approaches in cancer patients receiving targeted treatments. 

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Mormando, M.; Strinati, V.; Ciocca, E.; Bianchini, M.; Lauretta, R.; Puliani, G.; Appetecchia, M. Effect of New Oncological Therapies on Glucose Metabolism. Australian Journal of Oncology 2026, 1 (1), 3.
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