Autoimmune Encephalitis Related to Cancer Treatment With Immune Checkpoint Inhibitors:A Systematic Review
| Autor: | Vardan Nersesjan, Daniel Kondziella, Oskar McWilliam, Lars-Henrik Krarup |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Male
Oncology medicine.medical_specialty MEDLINE Antineoplastic Agents Hashimoto Disease Cochrane Library 03 medical and health sciences 0302 clinical medicine Neoplasms Internal medicine Epidemiology medicine Humans Adverse effect Immune Checkpoint Inhibitors Autoimmune encephalitis business.industry Melanoma Middle Aged medicine.disease Pathophysiology Treatment Outcome 030220 oncology & carcinogenesis Encephalitis Female Neurology (clinical) Nivolumab business 030217 neurology & neurosurgery |
| Zdroj: | Nersesjan, V, McWilliam, O, Krarup, L H & Kondziella, D 2021, ' Autoimmune Encephalitis Related to Cancer Treatment With Immune Checkpoint Inhibitors : A Systematic Review ', Neurology, vol. 97, no. 2, pp. e191-e202 . https://doi.org/10.1212/WNL.0000000000012122 |
| DOI: | 10.1212/WNL.0000000000012122 |
| Popis: | ObjectiveTo determine the clinical and laboratory features of immune checkpoint inhibitor (ICPI)–associated autoimmune encephalitis (ICPI-AIE), an increasingly recognized adverse event with ICPI treatment.MethodsWe searched PubMed, The Cochrane Library, and Embase for ICPI-AIE cases from the first description in 2015 until January 2020 using standard bibliographic measures including PRISMA guidelines and preregistration with PROSPERO.ResultsThirty-nine studies met inclusion criteria, resulting in 54 patients with ICPI-AIE (mean age 58.6 years; 43% female). Common cancers included melanoma (30%) and non-small cell lung cancer (30%). Brain metastases were found in 16 patients (30%). The most frequent ICPI was nivolumab (61%). Onset of ICPI-AIE occurred after a median of 3.0 treatment cycles, but very early and late presentations were common. Nonlimbic AIE was roughly twice as frequent as limbic AIE (p < 0.05). The most common laboratory abnormalities included bitemporal fluid-attenuated inversion recovery lesions on MRI, continuous slow waves and diffuse slowing on EEG, and monocytic pleocytosis on CSF analysis. Intraneuronal antibodies were more frequent than neuronal surface antibodies and a significant predictor for lack of improvement after first-line immunotherapy (p < 0.05).ConclusionsICPI-AIE consists of a heterogenous group of conditions. Neurologists will likely encounter ICPI-AIE more often in the future, but important unresolved questions include the pathophysiologic mechanisms, the epidemiology, and the best treatment approaches associated with ICPI-AIE. |
| Databáze: | OpenAIRE |
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