ReviewFrontiers in immunology2018
Fatal Necrotizing Encephalopathy after Treatment with Nivolumab for Squamous Non-Small Cell Lung Cancer: Case Report and Review of the Literature.
Review in Frontiers in immunology, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 28 papers, 1 of them a synthesis that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
28 citing papers in PubMed, 1 synthesis or guideline pooled it.
- [Neurological side effects of checkpoint inhibitors].Der Nervenarzt · 2019Pooled it
- Antibody-Negative Nivolumab-Induced Autoimmune Encephalitis: A Case Report and Review of Seronegative Presentations.Cureus · 2026Article
- Incongruence Between Prerequisite Molecular Testing and Treatment with Personalized Therapies for Non-Small Cell Lung Cancer: A Surveillance, Epidemiology and End Results-Medicare Study.International journal of molecular sciences · 2025Article
- Fatal Steroid-Refractory Autoimmune Encephalitis Following Sequential Immune Checkpoint Inhibitor Therapy in Squamous Non-Small Cell Lung Cancer.OncoTargets and therapy · 2025Article
- Dermatotoxicity of Immune Checkpoint Inhibitors in Advanced Non-Small Cell Lung Cancer: Current Advances in Mechanistic Insights and Predictive Biomarker Identification.Cancer management and research · 2025Review
- Multifocal disseminated necrotizing leukoencephalopathy as severe central nervous system toxicity from nivolumab therapy for Hodgkin lymphoma: a case report.Encephalitis (Seoul, Korea) · 2025Article
- Pentraxin 3: A Main Driver of Inflammation and Immune System Dysfunction in the Tumor Microenvironment of Glioblastoma.Cancers · 2024Review
- PD-1-induced encephalopathy: a report of 2 cases on neurological toxicities with immune checkpoint inhibitors.Translational cancer research · 2024Article
- A case report of the diagnosis and treatment of immune checkpoint inhibitor-related encephalitis induced by camrelizumab.AME case reports · 2024Article
- Investigation of response factors for monotherapy with immune checkpoint inhibitors in non-small cell lung cancer patients with PD-L1 expression <50.Thoracic cancer · 2023Article
- Stuttering as a signal of encephalopathy associated with toripalimab in a pancreatic ductal adenocarcinoma patient: a case report.BMC neurology · 2023Article
- Immune checkpoint inhibitor-associated toxicity in advanced non-small cell lung cancer: An updated understanding of risk factors.Frontiers in immunology · 2023Review
- Pembrolizumab-induced aseptic meningitis in a patient with non-small cell lung cancer: A case report and literature review of aseptic meningitis as an immune-related adverse event.Molecular and clinical oncology · 2022Article
- Advances in immunotherapy for glioblastoma multiforme.Frontiers in immunology · 2022Review
- Pembrolizumab-Induced Meningoencephalitis: A Brain Autopsy Case.Journal of medical cases · 2021Article
- Neurological complications induced by immune checkpoint inhibitors: a comprehensive descriptive case-series unravelling high risk of long-term sequelae.Brain communications · 2021Article
- Neurological Adverse Events Induced by Immune Checkpoint Inhibitors in Non-Small Cell Lung Cancer: Current Perspectives and New Development.Clinical Medicine Insights. Oncology · 2021Review
- Immune checkpoint inhibitor-induced aseptic meningitis and encephalitis: a case-series and narrative review.Therapeutic advances in drug safety · 2021Article
- Immune Checkpoint Inhibitors and Neurotoxicity.Current neuropharmacology · 2021Review
- Constitutional Mismatch Repair Deficiency Syndrome in a patient from India.Clinical case reports · 2020Article
Corrections and comments
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Authors and funding
11 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Immune checkpoint inhibitors are antibodies, which enhance cellular and humoral immune responses and are approved for the treatment of various tumors. Immune-related adverse events (irAE) involving different organs and systems are, however, among the side-effects. Recent reports of severe persistent neurological deficits and even fatal cases underpin the need for better understanding of the exact pathomechanisms of central nervous system (CNS) toxicity. To our knowledge, we report the first biopsy-proven case of fatal necrotizing encephalopathy after treatment with nivolumab. Nivolumab targets the immune-check point inhibitor programmed cell death-1 and was used for squamous non-small cell lung cancer. Partly reversible neurologic and psychiatric symptoms and unremarkable brain magnetic resonance imaging (MRI) were observed after the first course. Neurological symptoms progressed and recurrent seizures developed after the second course. Brain MRI disclosed multiple edematous and confluent supra- and infratentorial lesions, partly with contrast-enhancement. We excluded autoimmune and paraneoplastic causes and performed ancillary investigations to rule out common and opportunistic infections. Eventually, postmortem histopathological analysis of the brain revealed a necrotizing process, which contrasts previous cases reporting parenchymal immune cell infiltration or demyelination. Appropriate diagnostic pathways and treatment algorithms need to be implemented for the work-up of CNS toxicity and irAEs related to immune checkpoint inhibitor treatment.
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