The pathogenesis of neurological immune-related adverse events following immune checkpoint inhibitor therapy

Seminars in Immunology, Journal Year: 2025, Volume and Issue: 78, P. 101956 - 101956

Published: April 27, 2025

Cancer is a leading cause of morbidity and mortality worldwide. The development immune checkpoint inhibitors (ICI) has revolutionised cancer therapy, patients who were previously incurable can now have excellent responses. These therapies work by blocking inhibitory pathways, like cytotoxic T lymphocyte-associated protein 4 (CTLA-4), programmed cell death-1 (PD-1), its ligand PD-L1, lymphocyte activation gene 3 (LAG-3); which leads to increased anti-tumour However, their use lead the immune-related adverse events (irAEs), may result in severe disability, interruption even death. Neurological autoimmune sequelae occur 1-10 % treated with ICIs be fatal. They encompass broad spectrum diseases, affect central peripheral nervous system, include syndromes encephalitis, cerebellitis, neuropathy, myositis. In some cases, neurological irAEs associated autoantibodies recognising neuronal or glial targets. this review, we first describe key targets ICI followed formulation clinical presentations, where focus on syndromes. We comprehensively formulate current literature evaluating surface intracellular autoantibodies, cytokines, chemokines, leukocyte patterns, other blood derived biomarkers, immunogenetic profiles; highlight impact our understanding pathogenesis irAEs. Finally, therapeutic pathways patient outcomes, provide an overview future aspects therapy.

Language: Английский

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Case report: Immune checkpoint inhibitor-induced paraneoplastic neurological syndrome in two patients: a case series

Frontiers in Oncology, Journal Year: 2024, Volume and Issue: 14

Published: Oct. 28, 2024

Immune checkpoint inhibitors (ICIs) combined with chemotherapy have improved overall survival in patients small-cell lung cancer, but also led to an increase adverse effects. The incidence of ICI-induced paraneoplastic neurological syndrome (PNS) is relatively low when the primary lesion well controlled. However, it associated high mortality and disability rates. In this report, we present two cases extensive-stage cancer symptoms positive antibodies serum cerebrospinal fluid (CSF) following ICI therapy. Although after treatment systemic high-dose immunoglobulin glucocorticoids, one patient, unfortunately, succumbed tumor progression four months later, whereas other patient experienced persistent difficulty standing walking despite muscle strength. where that cannot be explained by metastases arise during treatment, syndromes should considered testing for antineuronal crucial, as early detection intervention can help mitigate their impact. Further research needed develop better predictive strategies protocols these reactions.

Language: Английский

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Cancer Therapy-Induced Encephalitis

Cancers, Journal Year: 2024, Volume and Issue: 16(21), P. 3571 - 3571

Published: Oct. 23, 2024

Encephalitis associated with cancer therapies is a rare but serious complication that can significantly impact patients' quality of life and it requires prompt identification management. Over the past two decades, immunotherapy-particularly immune checkpoint inhibitors-has become cornerstone treatment, up to half metastatic patients in economically developed countries now receiving these therapies. The widespread adoption immunotherapy has led improved survival rates long-term remissions, even advanced disease. However, as modulators, trigger range immune-related adverse events, including variety novel neurological toxicities. Among these, encephalitis particular concern due its potential severity, which compromise treatment outcomes. This review aims provide comprehensive overview literature on this condition, highlighting optimal diagnostic strategies management approaches mitigate risk significant morbidity, while also comparing induced by caused traditional chemotherapies targeted oncologic treatments.

Language: Английский

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History and novelties in autoimmune encephalitis and paraneoplastic neurological syndromes

Revue Neurologique, Journal Year: 2024, Volume and Issue: 180(9), P. 845 - 847

Published: Oct. 31, 2024

Language: Английский

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