Supportive Care in Cancer, Journal Year: 2024, Volume and Issue: 32(10)
Published: Sept. 25, 2024
Language: Английский
Cancers, Journal Year: 2024, Volume and Issue: 16(7), P. 1440 - 1440
Published: April 8, 2024
The landscape of cancer treatment has undergone a significant transformation with the introduction Immune Checkpoint Inhibitors (ICIs). Patients undergoing these treatments often report prolonged clinical and radiological responses, albeit potential risk developing immune-related adverse events (irAEs). Here, we reviewed discussed mechanisms action ICIs their pivotal role in regulating immune system to enhance anti-tumor response. We scrutinized intricate pathogenic responsible for irAEs, arising from evasion self-tolerance checkpoints due drug-induced modulation. also summarized main manifestations irAEs categorized by organ types, detailing incidence associated factors. occurrence is more frequent when are combined; neurological, cardiovascular, hematological, rheumatic commonly linked PD1/PD-L1 inhibitors cutaneous gastrointestinal prevalent CTLA4 inhibitors. Due often-nonspecific signs symptoms, diagnosis (especially those rare ones) can be challenging. differential primary autoimmune disorders becomes sometimes intricate, given pathophysiological similarities. In conclusion, considering escalating use ICIs, this area research necessitates additional studies practical insights, especially development biomarkers predicting toxicities. addition, there need heightened education both clinicians patients understanding awareness.
Language: Английский
Citations
19
The Lancet Regional Health - Europe, Journal Year: 2024, Volume and Issue: 44, P. 101011 - 101011
Published: July 25, 2024
Immune checkpoint inhibitor-related encephalitis (ICI-encephalitis) is not well characterised and diagnostic prognostic biomarkers are lacking. We aimed to comprehensively characterise ICI-encephalitis identify outcome predictors.
Language: Английский
Citations
9
Cancer Immunology Immunotherapy, Journal Year: 2025, Volume and Issue: 74(2)
Published: Jan. 3, 2025
Language: Английский
Citations
1
Neuron, Journal Year: 2025, Volume and Issue: unknown
Published: Jan. 1, 2025
Language: Английский
Citations
1
JACC CardioOncology, Journal Year: 2025, Volume and Issue: unknown
Published: March 1, 2025
Language: Английский
Citations
1
Nature Reviews Neurology, Journal Year: 2024, Volume and Issue: 20(9), P. 509 - 525
Published: Aug. 9, 2024
Language: Английский
Citations
7
Current Opinion in Neurology, Journal Year: 2024, Volume and Issue: 37(3), P. 345 - 352
Published: March 14, 2024
Purpose of review Immune checkpoint inhibitors (ICI) may trigger immune-related adverse events which rarely affect the central nervous system (CNS-irAEs). Over past few years, cumulative data have led to characterization well defined syndromes with distinct cancer and antibody associations as different outcomes. Recent findings The most frequent CNS-irAE is encephalitis, includes three main groups: meningoencephalitis, a nonfocal syndrome usually responsive corticosteroids; limbic associated high-risk paraneoplastic neurological (PNS) antibodies (e.g. anti-Hu, anti-Ma2) neuroendocrine cancers, characterized by poor treatment response outcomes; cerebellar ataxia, variable outcomes (worse when PNS are detected). Additionally, diffuse encephalopathy without inflammatory findings, corticosteroids high mortality has been described. spectrum CNS-irAEs also meningitis, myelitis, rarer presentations. A subset (i.e. encephalitis and/or rapidly progressive ataxia) undistinguishable from ICI-naïve PNS. Summary clinical diversity suggests pathogenic mechanisms, need be understood establish more effective specific modalities. It crucial identify biomarkers able predict patients will experience severe CNS-irAEs, anticipate their diagnosis, long-term
Language: Английский
Citations
5
Current Opinion in Neurology, Journal Year: 2024, Volume and Issue: 37(3), P. 305 - 315
Published: April 26, 2024
Purpose of review To provide an overview the pathogenic mechanisms involved in autoimmune encephalitides mediated by antibodies against neuronal surface antigens, with a focus on NMDAR and LGI1 encephalitis. Recent findings In antibody-mediated encephalitides, binding IgG to antigens results different effects depending type antibody, subclass epitope specificity. IgG1 cause crosslinking internalization target, synaptic brain circuitry alterations, as well alterations expressing oligodendrocytes, suggesting link white matter lesions observed MRI studies. IgG4 antibodies, instead, induce dysfunction disrupting interaction cognate proteins altering AMPAR-mediated signaling. In-vitro have been corroborated memory behavioral changes animal models obtained passive transfer patients’ or active immunization. These fundamental identify targets for innovative therapeutic strategies, aimed at counteracting preventing antibody effects, such use soluble ephrin-B2, modulators (e.g., pregnenolone, SGE-301) chimeric autoantibody receptor T cells (CAART) Summary A deep understanding underlying is crucial development new approaches targeting autoimmunity.
Language: Английский
Citations
5
Annals of Neurology, Journal Year: 2024, Volume and Issue: 96(1), P. 21 - 33
Published: April 18, 2024
Objectives To report an autoimmune paraneoplastic encephalitis characterized by immunoglobulin G (IgG) antibody targeting synaptic protein calmodulin kinase‐like vesicle‐associated (CAMKV). Methods Serum and cerebrospinal fluid (CSF) samples harboring unclassified antibodies on murine brain‐based indirect immunofluorescence assay (IFA) were screened human microarray. In 5 patients with identical cerebral IFA staining, CAMKV was identified as top‐ranking candidate antigen. Western blots, confocal microscopy, immune‐absorption, mass spectrometry performed to substantiate specificity. Recombinant CAMKV‐specific assays (cell‐based [fixed live] blot) provided additional confirmation. Results Of CAMKV‐IgG positive patients, 3 women (median symptom‐onset age 59 years; range, 53–74). Encephalitis‐onset subacute (4) or acute (1) manifested with: altered mental status (all), seizures (4), hyperkinetic movements psychiatric features (3), memory loss (2), insomnia (2). Paraclinical testing revealed CSF lymphocytic pleocytosis (all 4 tested), electrographic (3 of striking MRI abnormalities in all (mesial temporal lobe T2 hyperintensities [all patients], caudate head [3], cortical diffusion weighted [2]). None had post‐gadolinium enhancement. Cancers uterine adenocarcinoma patients: poorly differentiated neuroendocrine‐differentiated 2, both demonstrated immunoreactivity), bladder urothelial carcinoma (1), non‐Hodgkin lymphoma (1). Two developed following immune checkpoint inhibitor cancer therapy (atezolizumab [1], pembrolizumab [1]). All treated initial response immunotherapy (corticosteroids [4], IVIG [2]), though died from cancer. Interpretation is a biomarker immunotherapy‐responsive extratemporal prominent oncologic association. ANN NEUROL 2024;96:21–33
Language: Английский
Citations
4
Neurology Neuroimmunology & Neuroinflammation, Journal Year: 2024, Volume and Issue: 11(6)
Published: Sept. 19, 2024
The clinical course and the risk of chronicity neurologic immune-related adverse events (n-irAEs) associated with immune checkpoint inhibitors (ICIs) are not well documented. This study aimed to characterize n-irAEs assess prevalence chronic events.
Language: Английский
Citations
4