Neurological complications of immune checkpoint inhibitor cancer immunotherapy

2021 ◽  
Vol 424 ◽  
pp. 117424
Author(s):  
Cecilia Zivelonghi ◽  
Anastasia Zekeridou
Keyword(s):  
Cancer Immunotherapy ◽  
Immune Checkpoint ◽  
Immune Checkpoint Inhibitor ◽  
Checkpoint Inhibitor ◽  
Neurological Complications

scholarly journals Paraneoplastic Neurological Syndromes and Beyond Emerging With the Introduction of Immune Checkpoint Inhibitor Cancer Immunotherapy

2021 ◽  
Vol 12 ◽  
Author(s):  
Cristina Valencia-Sanchez ◽  
Anastasia Zekeridou
Keyword(s):  
Nervous System ◽  
Cancer Immunotherapy ◽  
Immune Checkpoint ◽  
Immune Checkpoint Inhibitor ◽  
Checkpoint Inhibitor ◽  
Checkpoint Inhibitors ◽  
Neurological Complications ◽  
High Dose ◽  
Paraneoplastic Neurological Syndromes ◽  
Clinical Presentations

Paraneoplastic neurological syndromes are more commonly seen with malignancies such as small cell lung cancer, thymoma, gynecological malignancies, and breast cancer as well as seminoma. With the introduction of immune checkpoint inhibitor (ICI) cancer immunotherapy we see an increase of autoimmune neurological complications in patients with malignancies not traditionally associated with paraneoplastic neurological syndromes, such as melanoma and renal cell carcinoma. Immune checkpoint inhibitors enhance antitumor immune responses resulting often in immune-related adverse effects that can affect any organ, including the central and peripheral nervous system, neuromuscular junction and muscle. Neurological complications are rare; neuromuscular complications are more common than central nervous system ones but multifocal neurological presentations are often encountered. The vast majority of neurological complications appear within 3 months of ICI initiation, but have been described even after ICI cessation. Neural autoantibody testing reveals autoantibodies in approximately half of the patients with CNS complications. Early suspicion and diagnosis is critical to avoid worsening and improve outcomes. Therapeutic strategies depend on the severity of the symptoms and initially typically involve discontinuation of ICI and high dose steroids. Further immunosuppression might be necessary. Outcomes are dependent on patient's characteristics and clinical presentations.

scholarly journals NCCN Guidelines Insights: Management of Immunotherapy-Related Toxicities, Version 1.2020

2020 ◽  
Vol 18 (3) ◽  
pp. 230-241 ◽  
Author(s):  
John A. Thompson ◽  
Bryan J. Schneider ◽  
Julie Brahmer ◽  
Stephanie Andrews ◽  
Philippe Armand ◽  
...  
Keyword(s):  
Adverse Events ◽  
Cancer Immunotherapy ◽  
Immune Checkpoint ◽  
Immune Checkpoint Inhibitor ◽  
Checkpoint Inhibitor ◽  
Nccn Guidelines

The NCCN Guidelines for Management of Immunotherapy-Related Toxicities provide interdisciplinary guidance on the management of immune-related adverse events (irAEs) resulting from cancer immunotherapy. These NCCN Guidelines Insights describe symptoms that may be caused by an irAE and should trigger further investigation, and summarize the NCCN Management of Immunotherapy-Related Toxicities Panel discussions for the 2020 update to the guidelines regarding immune checkpoint inhibitor–related diarrhea/colitis and cardiovascular irAEs.

Effect of gut microbiota on immune checkpoint inhibitor (ICI) based cancer immunotherapy

2021 ◽  
Vol 50 (4) ◽  
pp. 423
Author(s):  
A. Y. P. Perera ◽  
S. D. S. S. Sooriyapathirana ◽  
S. Rajapakse ◽  
J. A. M. S. Jayatilake
Keyword(s):  
Gut Microbiota ◽  
Cancer Immunotherapy ◽  
Immune Checkpoint ◽  
Immune Checkpoint Inhibitor ◽  
Checkpoint Inhibitor

scholarly journals Fundamental and Essential Knowledge for Pathologists Engaged in the Research and Practice of Immune Checkpoint Inhibitor-Based Cancer Immunotherapy

2021 ◽  
Vol 11 ◽  
Author(s):  
Terufumi Kubo ◽  
Tomoyo Shinkawa ◽  
Yasuhiro Kikuchi ◽  
Kenji Murata ◽  
Takayuki Kanaseki ◽  
...  
Keyword(s):  
Cancer Immunotherapy ◽  
Immune Checkpoint ◽  
Immune Checkpoint Inhibitor ◽  
Checkpoint Inhibitor ◽  
Predictive Biomarkers ◽  
Daily Practice ◽  
Basic Knowledge ◽  
Histopathological Analysis ◽  
Essential Knowledge

Extensive research over 100 years has demonstrated that tumors can be eliminated by the autologous immune system. Without doubt, immunotherapy is now a standard treatment along with surgery, chemotherapy, and radiotherapy; however, the field of cancer immunotherapy is continuing to develop. The current challenges for the use of immunotherapy are to enhance its clinical efficacy, reduce side effects, and develop predictive biomarkers. Given that histopathological analysis provides molecular and morphological information on humans in vivo, its importance will continue to grow. This review article outlines the basic knowledge that is essential for the research and daily practice of immune checkpoint inhibitor-based cancer immunotherapy from the perspective of histopathology.

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