Immune checkpoint inhibitors-induced neuromuscular toxicity: From pathogenesis to treatment.
Antibodies, Monoclonal, Humanized
/ therapeutic use
Antineoplastic Agents, Immunological
/ adverse effects
Humans
Immunoglobulins, Intravenous
/ therapeutic use
Immunologic Factors
/ adverse effects
Immunotherapy
/ adverse effects
Neuromuscular Diseases
/ chemically induced
Programmed Cell Death 1 Receptor
/ antagonists & inhibitors
Treatment Outcome
CTLA-4
PD-1
PD-L1
demyelinating polyradiculoneuropathy
immune checkpoint inhibitor
myasthenia gravis
myositis
nivolumab
pembrolizumab
peripheral neuropathy
Journal
Journal of the peripheral nervous system : JPNS
ISSN: 1529-8027
Titre abrégé: J Peripher Nerv Syst
Pays: United States
ID NLM: 9704532
Informations de publication
Date de publication:
Oct 2019
Oct 2019
Historique:
received:
03
06
2019
accepted:
15
07
2019
pubmed:
9
8
2019
medline:
23
4
2020
entrez:
9
8
2019
Statut:
ppublish
Résumé
Immune checkpoint inhibitors (ICIs) are increasingly used and are becoming the standard of care in the treatment of various tumor types. Despite the favorable results in terms of oncological outcomes, these treatments have been associated with a variety of immune-related adverse events (irAEs). Neurological irAEs are rare but potentially severe. Neuromuscular disorders represent the most common neurological irAEs following anti-PD-1, anti-PD-L1, and anti-CTLA-4 treatment, and include myositis, myasthenia gravis, and demyelinating polyradiculoneuropathy. Instrumental findings may differ from typical neuromuscular disorders occurring outside ICIs treatment. Despite initial severity, neurological irAEs often respond to immune-modulating therapies. Prompt irAEs diagnosis, ICIs discontinuation, and early treatment with corticosteroids, together with patient education and a multi-disciplinary approach, are important for optimizing clinical outcomes. Intravenous immunoglobulin, plasma exchange, and other immune-modulating treatments should be considered in more severe cases. Consideration of re-challenging with the same immunotherapy drug may be given in some cases, based on clinical picture and initial severity of irAEs.
Substances chimiques
Antibodies, Monoclonal, Humanized
0
Antineoplastic Agents, Immunological
0
Immunoglobulins, Intravenous
0
Immunologic Factors
0
PDCD1 protein, human
0
Programmed Cell Death 1 Receptor
0
Types de publication
Journal Article
Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
S74-S85Informations de copyright
© 2019 Peripheral Nerve Society.
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