ArticleNeurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology2022
Characterization and management of neurological adverse events during immune-checkpoint inhibitors treatment: an Italian multicentric experience.
Article in Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers, 3 of them syntheses that pooled it.
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22 citing papers in PubMed, 3 syntheses or guidelines pooled it, 33 citations in OpenAlex.
- Guidelines on the Use of Therapeutic Apheresis in Clinical Practice-Evidence-Based Approach From the Writing Committee of the American Society for Apheresis: The Tenth Special Issue.Journal of clinical apheresis · 2026Guideline
- Immune checkpoint inhibitors-associated cranial nerves involvement: a systematic literature review on 136 patients.Journal of neurology · 2024Pooled it
- Autoimmune Movement Disorders Complicating Treatment with Immune Checkpoint Inhibitors.Movement disorders clinical practice · 2024Pooled it
- Multidimensional Assessment of Neurological Adverse Reactions Related to PD-1 Inhibitors: A Real-World Pharmacovigilance Study.CNS neuroscience & therapeutics · 2026Article
- Adverse drug reaction assessment of pembrolizumab and nivolumab in esophageal cancer treatment based on the US FAERS database.Frontiers in immunology · 2026Article
- Editorial: Toward predictive and mechanistic approaches for precision neuroimmunotoxicology.Frontiers in immunology · 2026Article
- Neuromuscular complications associated with cancer immunotherapy.Journal of the National Cancer Center · 2025Review
- Rechallenge with immune-checkpoint inhibitors in patients with advanced-stage lung cancer.Nature reviews. Clinical oncology · 2025Review
- Case Report: Successful immune checkpoint inhibitor rechallenge after sintilimab-induced Guillain-Barré syndrome.Frontiers in immunology · 2025Article
- Immune checkpoint inhibitor-induced AMPA2 antibody-positive encephalitis: a case report.Frontiers in oncology · 2025Article
- Clinical Course of Neurologic Adverse Events Associated With Immune Checkpoint Inhibitors: Focus on Chronic Toxicities.Neurology(R) neuroimmunology & neuroinflammation · 2024Article
- Comparison Between Sotorasib with Docetaxel for the Treatment of Chinese Patients with Previously Treated NSCLC with KRASG12C Mutation: A Cost-Effectiveness Analysis to Inform Drug Pricing.Advances in therapy · 2024Article
- Unravelling the Acute, Chronic and Steroid-Refractory Management of High-Grade Neurological Immune-Related Adverse Events: A Call to Action.Brain sciences · 2024Review
- Neurological Adverse Events Related to Immune Checkpoint Inhibitors: A Practical Review.Pharmaceuticals (Basel, Switzerland) · 2024Review
- Neurologic Complications of Cancer Immunotherapy.Current oncology (Toronto, Ont.) · 2023Review
- Transcriptomic profiling reveals distinct subsets of immune checkpoint inhibitor induced myositis.Annals of the rheumatic diseases · 2023Article
- [Rheumatological side effects of checkpoint inhibitors and their treatment].Zeitschrift fur Rheumatologie · 2023Review
- Mechanism and Management of Checkpoint Inhibitor-Related Toxicities in Genitourinary Cancers.Cancers · 2022Review
- Association Between Clinical Factors and Result of Immune Checkpoint Inhibitor Related Myasthenia Gravis: A Single Center Experience and Systematic Review.Frontiers in neurology · 2022Article
- [Management of immune-related adverse events (irAEs) - what needs to be respected?]Der Gynakologe · 2022Review
Corrections and comments
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Authors and funding
19 authors at 7 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundNeurological immune-related adverse events (nirAEs) are rare toxicities of immune-checkpoint inhibitors (ICI). With the increase of ICI oncological indications, their incidence is growing. Their recognition and management remain nevertheless challenging.
methodsA national, web-based database was built to collect cases of neurological symptoms in patients receiving ICI and not attributable to other causes after an adequate workup.
resultsWe identified 27 patients who developed nirAEs (20 males, median age 69 years). Patients received anti-PD1/PDL1 (78%), anti-CTLA4 (4%), or both (19%). Most common cancers were melanoma (30%) and non-small cell lung cancer (26%). Peripheral nervous system was mostly affected (78%). Median time to onset was 43.5 days and was shorter for peripheral versus central nervous system toxicities (36 versus 144.5 days, p = 0.045). Common manifestations were myositis (33%), inflammatory polyradiculoneuropathies (33%), and myasthenia gravis (19%), alone or in combination, but the spectrum of diagnoses was broad. Most patients received first-line glucocorticoids (85%) or IVIg (15%). Seven patients (26%) needed second-line treatments. At last follow-up, four (15%) patients were deceased (encephalitis, 1; myositis/myasthenia with concomitant myocarditis, 2; acute polyradiculoneuropathy, 1), while seven (26%) had a complete remission, eight (30%) partial improvement, and six (22%) stable/progressing symptoms. ICI treatment was discontinued in most patients (78%).
conclusionsNeurological irAEs are rare but potentially fatal. They primarily affect neuromuscular structures but encompass a broad range of presentations. A prompt recognition is mandatory to timely withheld immunotherapy and administrate glucocorticoids. In corticoresistant or severely affected patients, second-line treatments with IVIg or plasmapheresis may result in additional benefit.
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