Neurologic Immune-Related Adverse Events Associated with Immune Checkpoint Inhibition

Curr Oncol Rep. 2019 Nov 27;21(12):108. doi: 10.1007/s11912-019-0859-2.

Abstract

Purpose of review: This review highlights the spectrum of neurologic adverse events seen with use of immune checkpoint inhibitors (ICIs), their potential mechanisms, the treatments undertaken, and the clinical outcomes.

Recent findings: The advent of ICIs has revolutionized cancer therapy. Neurologic adverse events (NAEs) are rare but clinically significant complication of ICIs. They can involve both the central and peripheral nervous system. Examples include myositis, neuropathy, encephalopathy, and myasthenia gravis. Treatment consists of holding the ICI, administration of corticosteroids, and other immunomodulatory agents as needed. The outcomes are generally favorable; however, rarely severe events can lead to significant morbidity and even mortality. Identifying and treating the range of neurologic adverse events that may potentially arise with ICIs is very important as the oncologic indications for their use continues to expand.

Keywords: AIDP; Anti-CTLA4; Anti-PD1; Anti-PDL1; Encephalitis; Guillain-Barre syndrome; Immune checkpoint inhibitor; Immunotherapy; Meningitis; Myasthenia gravis; Neurologic adverse events; Neuropathy; Neurotoxicity; Paraneoplastic syndrome.

Publication types

  • Review

MeSH terms

  • Antineoplastic Agents, Immunological / adverse effects*
  • Humans
  • Immunotherapy / adverse effects*
  • Neoplasms / drug therapy*
  • Neoplasms / immunology
  • Neoplasms / pathology
  • Nervous System Diseases / chemically induced*
  • Nervous System Diseases / immunology
  • Nervous System Diseases / pathology*
  • Prognosis

Substances

  • Antineoplastic Agents, Immunological