Acute progressive neuropathy–myositis–myasthenia-like syndrome associated with immune-checkpoint inhibitor therapy in patients with metastatic melanoma
| Autor: | Kurt-Wolfram Sühs, Nora Möhn, Martin Stangel, Ralf Gutzmer, Imke Satzger, Thomas Skripuletz, Stefan Gingele, Yenny Angela |
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| Rok vydání: | 2019 |
| Předmět: |
Male
0301 basic medicine Oncology Cancer Research medicine.medical_specialty Weakness Skin Neoplasms Neurological examination Ipilimumab Dermatology Antibodies Monoclonal Humanized 03 medical and health sciences Therapeutic approach Antineoplastic Agents Immunological 0302 clinical medicine Internal medicine Blocking antibody Humans Medicine Adverse effect Melanoma Myositis Aged 80 and over medicine.diagnostic_test business.industry Peripheral Nervous System Diseases Syndrome Middle Aged medicine.disease 030104 developmental biology 030220 oncology & carcinogenesis Acute Disease Female Nivolumab medicine.symptom business Paraneoplastic Syndromes Nervous System medicine.drug |
| Zdroj: | Melanoma Research. 29:435-440 |
| ISSN: | 0960-8931 |
| DOI: | 10.1097/cmr.0000000000000598 |
| Popis: | Targeting immune cells instead of cancer cells is a new and successful therapeutic approach in patients with a variety of advanced cancers. Blocking antibodies bind to specific immune-checkpoint molecules namely cytotoxic T-lymphocyte-associated antigen 4, programmed cell death protein-1, and programmed cell death-ligand 1. However, their mechanism of action can lead to immune-related adverse events. In particular, neurological immune-related adverse events present, currently, a problem, as they are rare, difficult to diagnose, and are often high grade or even fatal. Here, we describe four cases with metastatic melanoma who developed symptoms of acute progressive weakness 3-9 weeks after therapy onset with immune-checkpoint inhibitors (ICIs) nivolumab and ipilimumab. Neurological examination and diagnostic procedures revealed results partly consistent with neurological disorders such as neuropathy, myositis, and myasthenia. This suggests an overlap of these known diseases indicating a new ICI-induced neuropathy-myositis-myasthenia-like syndrome. Here, we give recommendations for a structured and focused diagnostic assessment in patients presenting with neurological deficits during ICI therapy. This might improve the understanding, management, and ultimately the outcome of ICI-induced neurological adverse events. |
| Databáze: | OpenAIRE |
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