Neurotoxicity in the Era of Immune Checkpoint Inhibitors: A Case-Based Approach
Received Date : 30 May 2024
Accepted Date : 21 Oct 2024
Available Online : 25 Nov 2024
Özkan ALANa, Yunus Emre ALTINTAŞa, Buket BAYRAM KUVVETb, Arda DUMANc,
Mustafa Cem BÜLBÜLb, Oğuz ÇELEBİb, Murat Serhat AYGÜNd, Bahadır KÖYLÜa,
Sinem AKBAŞa, Şahin LAÇİNa, Piraye OFLAZERc, Fatih SELÇUKBİRİCİKa,
Nil Molinas MANDELa
aKoç University Faculty of Medicine, Divison of Medical Oncology, İstanbul, Türkiye
bKoç University Faculty of Medicine, Department of Internal Medicine, İstanbul, Türkiye
cKoç University Faculty of Medicine, Department of Neurology, İstanbul, Türkiye
dKoç University Faculty of Medicine, Department of Radiology, İstanbul, Türkiye
Doi: 10.37047/jos.2024-104195 - Article's Language: EN
J Oncol Sci.
ABSTRACT
Immune checkpoint inhibitors (ICIs) have transformed the field of cancer immunotherapy and led to substantial improvements in
patient outcomes across various malignancies. Neurological toxicities arising from ICI treatment represent a heterogeneous group of complications
that manifest across a broad spectrum, ranging from mild symptoms to life-threatening conditions. The present article reviews patients receiving
ICI treatment and identifies neurological adverse events observed across all ICI therapeutic modalities. Data were retrospectively evaluated
from 500 cancer patients who received immunotherapy treatment between 2020-2022 at Koç University Hospital Medical Oncology Outpatient
Clinic. Eight patients (1.6%) who developed immunotherapy-related neurologic side effects were included in the analysis. Demographic and
clinicopathologic characteristics, along with laboratory results, were extracted from the medical oncology outpatient clinic database. In this study,
89% (7/8) of the patients were male, with a median age of 59 years (range 44-79). The most common cancer types observed were small cell lung
cancer (n=2) and renal cell carcinoma (n=2). A case study is also presented of a patient who developed neurotoxicity following immunotherapy.
Immunotherapy emergence has marked substantial advancement in cancer treatment approaches, although neurological side effects require close
monitoring. Recognition of diverse neurological complications associated with ICIs and their potential severity remains essential for clinical
practice.
Keywords: Immune related adverse events; immune checkpoint inhibitors; immunotherapy; neurological adverse events; neurological toxicities