Severe neurologic complications of immune checkpoint inhibitors: a single-center review

Journal of Neurology
Sarah ManconeRoy E Strowd

Abstract

Immune checkpoint inhibitors (ICIs) are a promising class of anticancer drugs associated with immune-related adverse events (IRAEs). In registration studies of selected cancer populations, neurologic IRAEs were rare. Post-marketing experience describing their prevalence in clinical practice continues to be reported. A retrospective cohort of patients treated at our institution with ICIs from 2005 to 2017 was identified. Patients with new neurologic ICD codes documented during or after ICI treatment were enrolled. Comprehensive medical record review identified patients with neurologic IRAEs causally linked to ICIs. This study focused on CTCAE grade 2-4 IRAEs. 526 patients were screened; 55 candidate patients were identified; 5 cases met criteria for neurologic IRAEs, an incidence of 0.95% (n = 5/526). IRAEs identified were transverse myelopathy, demyelinating sensorimotor polyneuropathy, oculomotor nerve palsy, sensory neuropathy, and posterior reversible encephalopathy syndrome. ICIs were held in three patients, rechallenged in one, and dose-reduced in one. Corticosteroids were given in three patients, and response varied from complete symptom resolution to minimal response and ultimately death. Other treatments were based on I...Continue Reading

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Citations

Oct 20, 2018·Future Oncology·Nicole A Carreau, Anna C Pavlick
Feb 23, 2019·American Journal of Hematology·Rebecca Karp LeafDavid E Leaf
Mar 14, 2019·Journal of the National Comprehensive Cancer Network : JNCCN·John A ThompsonJillian L Scavone
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Feb 2, 2019·Annals of Intensive Care·Virginie LemialeUNKNOWN Groupe de Recherche en Reanimation Respiratoire du patient d’Onco-Hématologie (Grrr-OH)
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Jan 30, 2019·Surgical Oncology·Nicole Carreau, Anna Pavlick
Jan 12, 2021·IJU Case Reports·Toshiki OkaKazuo Nishimura
Dec 29, 2020·Expert Opinion on Therapeutic Targets·Jennifer E KimChristopher M Jackson
Nov 12, 2020·Eye and Brain·Caberry W YuJonathan A Micieli
Jun 2, 2020·Critical Reviews in Oncology/hematology·Ioannis ParthymosMatilda Florentin
Apr 1, 2021·Drugs·Blake H FortesLauren A Dalvin
Mar 4, 2021·Neurology·Alessandro MariniAlberto Vogrig
Dec 16, 2020·Neurology·Alberto VogrigJérôme Honnorat

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