In the CAPItello-291 trial, hyperglycemia was reported in 16.9% of patients (grade ≥3 in 2.3%), typically within the first two weeks (median onset, 15 days).1) Most cases were transient and manageable with short-term insulin or metformin use in affected patients.8) Similarly, in Japanese postmarketing surveillance, which included approximately 350 patients, 31 cases of hyperglycemia and six acute hyperglycemic complications (including DKA and hyperosmolar hyperglycemic syndrome) were reported. The gene discussed is INS; the disease is Hyperglycemia.