Neurological adverse events associated with immune checkpoint inhibitors: Review of the literature
| Autor: | F. Javeri, Ciprian Barlog, A Roumi, Antoine F. Carpentier, Jennifer Doridam, Stefania Cuzzubbo, Céleste Lebbé, Catherine Belin, Renata Ursu, M. Tissier |
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| Rok vydání: | 2017 |
| Předmět: |
Drug
Cancer Research medicine.medical_specialty Immune checkpoint inhibitors media_common.quotation_subject Programmed Cell Death 1 Receptor Antineoplastic Agents 03 medical and health sciences 0302 clinical medicine Neoplasms Internal medicine medicine Humans CTLA-4 Antigen Molecular Targeted Therapy Adverse effect media_common business.industry Incidence Incidence (epidemiology) Antibodies Monoclonal Cancer medicine.disease Clinical trial Oncology 030220 oncology & carcinogenesis Immunology Immunotherapy Nervous System Diseases Headaches medicine.symptom business Meningitis 030217 neurology & neurosurgery |
| Zdroj: | European Journal of Cancer. 73:1-8 |
| ISSN: | 0959-8049 |
| DOI: | 10.1016/j.ejca.2016.12.001 |
| Popis: | Immune checkpoint inhibitors (ICIs) targeting CTLA4 and PD1 constitute a promising class of cancer treatment but are associated with several immune-related disorders. We here review the literature reporting neurological adverse events (nAEs) associated with ICIs. A systematic search of literature, up to February 2016, mentioning nAEs in patients treated with ICIs was conducted. Eligible studies included case reports and prospective trials. One case seen in our ward was also added. Within the 59 clinical trials (totalling 9208 patients) analysed, the overall incidence of nAEs was 3.8% with anti-CTLA4 antibodies, 6.1% with anti-PD1 antibodies, and 12.0% with the combination of both. The clinical spectrum of neurological disorders was highly heterogeneous. Most of these nAEs were grade 1–2 and consisted of non-specific symptoms such as headache (55%). The incidence of high grade nAEs was below 1% for all types of treatment. Headaches, encephalopathies and meningitis were the most commonly reported (21%, 19% and 15%, respectively). Among the 27 case reports, the most common nAEs were encephalopathies, meningoradiculoneuritis, Guillain-Barre like syndromes and myasthenic syndromes. The median time of nAEs onset was 6 weeks. In most cases, drug interruption and steroids led to neurological recovery, even in conditions where steroids are not usually recommended such as Guillain-Barre syndrome. |
| Databáze: | OpenAIRE |
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