Cranial Nerve Disorders Associated With Immune Checkpoint Inhibitors.
Abducens Nerve Diseases
/ chemically induced
Adult
Aged
Aged, 80 and over
Cranial Nerve Diseases
/ chemically induced
Facial Nerve Diseases
/ chemically induced
Female
Follow-Up Studies
Humans
Immune Checkpoint Inhibitors
/ adverse effects
Male
Middle Aged
Neoplasms
/ drug therapy
Oculomotor Nerve Diseases
/ chemically induced
Optic Neuritis
/ chemically induced
Retrospective Studies
Vestibulocochlear Nerve Diseases
/ chemically induced
Journal
Neurology
ISSN: 1526-632X
Titre abrégé: Neurology
Pays: United States
ID NLM: 0401060
Informations de publication
Date de publication:
09 02 2021
09 02 2021
Historique:
received:
13
05
2020
accepted:
12
10
2020
pubmed:
16
12
2020
medline:
24
2
2021
entrez:
15
12
2020
Statut:
ppublish
Résumé
To describe the spectrum, treatment, and outcome of cranial nerve disorders associated with immune checkpoint inhibitor (Cn-ICI). This nationwide retrospective cohort study on Cn-ICI (2015-2019) was conducted using the database of the French Refence Center. In addition, a systematic review of the literature (MEDLINE, Scopus, and Web of Science) for records published between 2010 and 2019 was performed following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines using the search terms cranial nerve or neuropathy or palsy and immune checkpoint inhibitors. Among 67 cases with ICI-related neurologic toxicities diagnosed in our reference center, 9 patients with Cn-ICI were identified (7 men, 78%, median age 62 years [range 26-82 years]). Patients were receiving a combination of anti-cytotoxic T-lymphocyte antigen 4 and anti-programmed cell death 1 (PD-1)/PD-1 ligand (n = 5, 56%) or anti-PD-1 antibodies alone (n = 4, 44%). Cn-ICI involved optic (n = 3), vestibulocochlear (n = 3), abducens (n = 2), facial (n = 2), and oculomotor (n = 1) nerves. Two patients had involvement of 2 different cranial nerves. Treatment comprised corticosteroids (n = 8, 89%), ICI permanent discontinuation (n = 7, 78%), plasma exchange (n = 2, 22%), and IV immunoglobulin (n = 1, 11%). Median follow-up was 11 months (range 1-41 months). In 3 cases (33%), neurologic deficit persisted/worsened despite treatment: 2 optic and 1 vestibulocochlear. Among cases from the literature and the present series combined (n = 39), the most commonly affected cranial nerves were facial (n = 13, 33%), vestibulocochlear (n = 8, 21%), optic (n = 7, 18%), and abducens (n = 4, 10%). Trigeminal, oculomotor, and glossopharyngeal nerves were less frequently affected (total n = 7). Cranial nerve disorders can complicate treatment with ICIs. Approximately one-third of the patients had persisting deficits, most frequently involving hearing and vision loss.
Identifiants
pubmed: 33318162
pii: WNL.0000000000011340
doi: 10.1212/WNL.0000000000011340
doi:
Substances chimiques
Immune Checkpoint Inhibitors
0
Types de publication
Case Reports
Journal Article
Research Support, Non-U.S. Gov't
Systematic Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
e866-e875Informations de copyright
© 2020 American Academy of Neurology.