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Neurological Adverse Events Associated with Immune Checkpoint Inhibitors: Diagnosis and Management

  • Neuro-Oncology (LE Abrey, Section Editor)
  • Published:
Current Neurology and Neuroscience Reports Aims and scope Submit manuscript

Abstract

Purpose of Review

Immune checkpoint inhibitors represent a major step forward in the field of oncologic immunotherapy these last years and have significantly increased survival of cancer patients in an ever-growing number of indications. These agents block specific immune checkpoint molecules (programmed cell death protein 1 and its ligand as well as cytotoxic T-lymphocyte-associated antigen 4) that normally downregulate the immune response. These new agents show a specific range of adverse effects induced by abnormal immunologic activation.

Recent Findings

Many different neurologic adverse events have been described, including encephalitis, myelopathy, aseptic meningitis, meningoradiculitis, Guillain-Barré-like syndrome, peripheral neuropathy (including mononeuropathy, mononeuritis multiplex, and polyneuropathy) as well as myasthenic syndrome.

Summary

Immune checkpoint inhibitors have shown promising results in cancer but can possibly induce autoimmune disorders. Although rare, neurological adverse events require prompt recognition and treatment to avoid substantial morbidity.

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Acknowledgements

The authors wish to thank Laurence Benoit for her administrative support.

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Author notes

  1. Christophoros Astaras and Rita de Micheli contributed equally to this work.

Authors and Affiliations

  1. Department of Oncology, CHUV Lausanne University Hospital and Lausanne University, 1011, Lausanne, Switzerland

    Christophoros Astaras, Rita de Micheli & Bianca Moura

  2. Departments of Neurology, Medical Oncology and Hematology, Cantonal Hospital, 9007, St. Gallen, Switzerland

    Thomas Hundsberger

  3. Department of Clinical Neurosciences and Oncology, CHUV Lausanne University Hospital and Lausanne University, 1011, Lausanne, Switzerland

    Andreas F. Hottinger

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  1. Christophoros Astaras
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  2. Rita de Micheli
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Correspondence to Andreas F. Hottinger.

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Christophoros Astaras, Rita de Micheli, and Bianca Moura declare no conflict of interest.

Andreas F. Hottinger reports grants from Novocure and Astellas, paid to his institution.

Thomas Hundsberger has received paid travel compensation from BMS Switzerland.

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This article is part of the Topical Collection on Neuro-Oncology

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Astaras, C., de Micheli, R., Moura, B. et al. Neurological Adverse Events Associated with Immune Checkpoint Inhibitors: Diagnosis and Management. Curr Neurol Neurosci Rep 18, 3 (2018). https://doi.org/10.1007/s11910-018-0810-1

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  • DOI: https://doi.org/10.1007/s11910-018-0810-1

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