Journal ArticleDOI
Neurologic Adverse Events of Immune Checkpoint Inhibitors: A Systematic Review.
Alessandro Marini,Alessandro Marini,Andrea Bernardini,Gian Luigi Gigli,Mariarosaria Valente,Mariarosaria Valente,Sergio Muñiz-Castrillo,Sergio Muñiz-Castrillo,Jérôme Honnorat,Jérôme Honnorat,Alberto Vogrig +10 more
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TLDR
The most common n-irAEs reports were myositis (136/428, 32%), Guillain-Barre syndrome and other peripheral neuropathies (94/428 and 22%), myasthenic syndromes (58/ 428, 14%), encephalitis (56/684, 13%), cranial neuropathia (31/428), 7%), meningitis (13/684), 3%), CNS demyelinating diseases (8/428 2%), and myelitis (7/684 2%) as discussed by the authors.Abstract:
OBJECTIVE To define the clinical characteristics, management, and outcome of neurologic immune-related adverse events (n-irAEs) of immune checkpoint inhibitors (ICIs). METHODS Systematic review of the literature following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. RESULTS A total of 694 articles were identified. Two hundred fifty-six articles, with 428 individual patients, met the inclusion criteria. Reports regarding neuromuscular disorders (319/428, 75%) were more frequent than those on CNS disorders (109/428, 25%). The most common n-irAEs reports were myositis (136/428, 32%), Guillain-Barre syndrome and other peripheral neuropathies (94/428, 22%), myasthenic syndromes (58/428, 14%), encephalitis (56/428, 13%), cranial neuropathies (31/428, 7%), meningitis (13/428, 3%), CNS demyelinating diseases (8/428, 2%), and myelitis (7/428, 2%). Other CNS disorders were detected in 25/428 (6%) patients. Compared with the whole sample, myasthenic syndromes were significantly more Ab positive (33/56, 59%; p < 0.001). Anti-programmed cell death protein 1/programmed cell death ligand 1 was more frequent in myasthenic syndromes (50/58, 86%; p = 0.005) and less common in meningitis (2/13, 15%; p < 0.001) and cranial neuropathies (13/31, 42%; p = 0.005). Anti-cytotoxic T-lymphocyte antigen-4 ICIs were more frequent in meningitis (8/13, 62%; p < 0.001) and less common in encephalitis (2/56, 4%; p = 0.009) and myositis (12/136, 9%; p = 0.01). Combination of different ICIs was more frequent in cranial neuropathies (12/31, 39%; p = 0.005). Melanoma was more frequent in patients with peripheral neuropathies (64/94, 68%; p = 0.003) and less common in encephalitis (19/56, 34%; p = 0.001). The highest mortality rate was reached in myasthenic syndromes (28%). CONCLUSION Considering the increasing use of ICI therapy in the forthcoming future, this information can be valuable in assisting neurologists and oncologists in early n-irAEs diagnosis and treatment.read more
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Neurological autoimmune diseases following vaccinations against SARS-CoV-2: a case series.
Leon D. Kaulen,Sofia Doubrovinskaia,Christoph Mooshage,Berit Jordan,Jan C. Purrucker,Carmen Haubner,Corinna Seliger,Hanns-Martin Lorenz,Simon Nagel,Brigitte Wildemann,Martin Bendszus,Wolfgang Wick,Silvia Schönenberger +12 more
TL;DR: In this article, a single-centre prospective case study patients with neurological autoimmunity in temporal association (≤6 weeks) with SARS-CoV-2 vaccinations and without other triggers are reported.
Journal ArticleDOI
Characterization and management of neurological adverse events during immune-checkpoint inhibitors treatment: an Italian multicentric experience.
Luca Diamanti,Alberto Picca,Paola Bini,Matteo Gastaldi,Enrico Alfonsi,Anna Pichiecchio,Eugenia Rota,Roberta Rudà,Francesco Bruno,Veronica Villani,Edvina Galiè,Alberto Vogrig,Mariarosaria Valente,Marco Zoccarato,Valentina Poretto,Bruno Giometto,Carolina Cimminiello,Michele Del Vecchio,Enrico Marchioni +18 more
TL;DR: In this paper, a national, web-based database was built to collect cases of neurological symptoms in patients receiving ICI and not attributable to other causes after an adequate workup.
Journal ArticleDOI
How to diagnose and manage neurological toxicities of immune checkpoint inhibitors: an update.
Alberto Vogrig,Alberto Vogrig,Sergio Muñiz-Castrillo,Sergio Muñiz-Castrillo,Antonio Farina,Antonio Farina,Jérôme Honnorat,Jérôme Honnorat,Bastien Joubert +8 more
TL;DR: In this paper, the authors provide an update of the recent advances in the diagnosis and treatment of neurological toxicities related to ICI use, focusing on the exclusion of alternative diagnoses, diagnostic specificities, and treatment.
Journal ArticleDOI
Neurotoxicity and safety of the rechallenge of immune checkpoint inhibitors: a growing issue in neuro-oncology practice
TL;DR: Current knowledge regarding presentation forms, diagnostic workflows, outcomes, and general management of n-irAEs are updated to guide neurologists in decision-making processes during such scenarios and available data on ICI reintroduction safety in patients with prior n-IRAEs is reviewed.
Journal ArticleDOI
Novelties in Autoimmune and Paraneoplastic Cerebellar Ataxias: Twenty Years of Progresses
Sergio Muñiz-Castrillo,Alberto Vogrig,Nicolás Lundahl Ciano-Petersen,Macarena Villagrán-García,Bastien Joubert,Jérôme Honnorat +5 more
TL;DR: Progress has additionally been made in the clinical characterization of patients with the main neural antibodies, which, although typically present with a subacute pancerebellar syndrome, may also show either hyperacute or chronic onsets that complicate the differential diagnoses.
References
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Taku Okazaki,Tasuku Honjo +1 more
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Journal ArticleDOI
The Price of Tumor Control: An Analysis of Rare Side Effects of Anti-CTLA-4 Therapy in Metastatic Melanoma from the Ipilimumab Network
Caroline J. Voskens,Simone M. Goldinger,Carmen Loquai,Caroline Robert,Katharina C. Kaehler,Carola Berking,Tanja Bergmann,Clemens L. Bockmeyer,Thomas Eigentler,Michael Fluck,Claus Garbe,Ralf Gutzmer,Stephan Grabbe,Axel Hauschild,Rüdiger Hein,Gheorghe Hundorfean,Armin Justich,Ullrich Keller,Christina Klein,Christine Mateus,Peter Mohr,Sylvie Paetzold,Imke Satzger,Dirk Schadendorf,Marc Schlaeppi,Gerold Schuler,Beatrice Schuler-Thurner,Uwe Trefzer,Jens Ulrich,Julia Vaubel,Roger von Moos,Patrik Weder,Tabea Wilhelm,Daniela Göppner,Reinhard Dummer,Lucie Heinzerling,Lucie Heinzerling +36 more
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Journal ArticleDOI
Neurological adverse events associated with immune checkpoint inhibitors: Review of the literature.
Stefania Cuzzubbo,F. Javeri,M. Tissier,A Roumi,Ciprian Barlog,Jennifer Doridam,Céleste Lebbé,Catherine Belin,Renata Ursu,Antoine F. Carpentier +9 more
TL;DR: In most cases, drug interruption and steroids led to neurological recovery, even in conditions where steroids are not usually recommended such as Guillain-Barré syndrome, and the median time of nAEs onset was 6 weeks.