Evidence map›Paper›PMID 33454891›Full record

ArticleJournal of neuro-oncology2021

Neurotoxicities associated with immune checkpoint inhibitor therapy.

Sophie L Duong, Frank J Barbiero, Richard J Nowak, Joachim M Baehring

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Article in Journal of neuro-oncology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 49 papers, 6 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
49citing papers in PubMed, 6 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

49 citing papers in PubMed, 6 syntheses or guidelines pooled it.

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  16. Immune checkpoint inhibition perturbs neuro-immune homeostasis and impairs cognitive function.Journal of experimental & clinical cancer research : CR · 2025
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors.

Sophie L DuongDepartment of Neurology, Yale School of Medicine, New Haven, CT, USA.
Frank J BarbieroDepartment of Neurology, Yale School of Medicine, New Haven, CT, USA.
Richard J NowakDepartment of Neurology, Yale School of Medicine, New Haven, CT, USA.
Joachim M BaehringDepartment of Neurosurgery, Yale School of Medicine, New Haven, CT, USA. joachim.baehring@yale.edu.ORCID http://orcid.org/0000-0001-7755-6793

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionImmune checkpoint inhibitors (ICIs) have emerged as a promising class of cancer immunotherapies. Neurotoxicities are uncommon, but often severe, and potentially fatal complications of ICIs, and clinical experience is limited. The aim of this study is to further define the clinical spectrum and outcome of ICI-mediated neurotoxicities.

methodsPatients with ICI-associated neurotoxicities were identified from retrospective review of the quality control database at a single institution. Data regarding demographics, medical history, clinical presentation, diagnosis, management and outcome were recorded.

resultsWe identified 18 patients with neurotoxicity following ICI therapy with pembrolizumab, nivolumab, atezolizumab, or ipilimumab for a diverse set of malignancies. Neurotoxicities comprised central demyelinating disorder (28%), autoimmune encephalitis predominantly affecting the grey matter (17%), aseptic meningitis (6%), myasthenia gravis (MG) (17%) with concurrent myositis (6%), sensorimotor polyneuropathy (11%) and hypophysitis (17%). Median time to onset of neurotoxicities was 5 weeks (range 1-72). All patients discontinued ICIs and received steroids with additional immunomodulation required in 9 patients, resulting in improvement for 16 of 18 patients. Grade 3-4 neurotoxicity developed in 14 patients, of whom 6 had died at database closure. Grade 3-4 severity negatively impacted overall survival (OS) (p = 0.046).

conclusionsICI-mediated neurotoxicities present early, are rapidly progressive and include a diverse phenotype affecting the CNS, PNS and neuroendocrine system. A high level of vigilance is warranted, as early diagnosis and targeted treatment can substantially prevent morbidity and mortality. Prospective clinical trials are warranted to assess optimized management of ICI-induced neurotoxicities.

Indexed as

Antibodies, Monoclonal, HumanizedHumansImmune Checkpoint InhibitorsIpilimumabNeoplasmsNeurotoxicity SyndromesNivolumabRetrospective StudiesAntibodies, Monoclonal, HumanizedatezolizumabImmune Checkpoint InhibitorsIpilimumabNivolumabpembrolizumabCancerCTLA4ImmunotherapyNeurologic immune-related adverse eventsPD1

Identifiers

PMID33454891

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.