Neurological adverse events of immune checkpoint inhibitors and the development of paraneoplastic neurological syndromes.

Abstract

Immune checkpoint inhibitors, a class of oncological treatments that enhance antitumour immunity, can trigger neurological adverse events closely resembling paraneoplastic neurological syndromes. Unlike other neurological adverse events caused by these drugs, post-immune checkpoint inhibitor paraneoplastic neurological syndromes predominantly affect the CNS and are associated with neural antibodies and cancer types commonly found also in spontaneous paraneoplastic neurological syndromes. Furthermore, post-immune checkpoint inhibitor paraneoplastic neurological syndromes have poorer neurological outcomes than other neurological adverse events of immune checkpoint inhibitors. Early diagnosis and initiation of immunosuppressive therapy are likely to be crucial in preventing the accumulation of neurological disability. Importantly, the neural antibodies found in patients with post-immune checkpoint inhibitor paraneoplastic neurological syndromes are sometimes detected before treatment, indicating that these antibodies might help to predict the development of neurological adverse events. Experimental and clinical evidence suggests that post-immune checkpoint inhibitor paraneoplastic neurological syndromes probably share immunological features with spontaneous paraneoplastic syndromes. Hence, the study of post-immune checkpoint inhibitor paraneoplastic neurological syndromes can help in deciphering the immunopathogenesis of paraneoplastic neurological syndromes and in identifying novel therapeutic targets.

• Authors: Antonio Farina, Macarena Villagrán-García, Alberto Vogrig, Anastasia Zekeridou, Sergio Muñiz-Castrillo, Roser Velasco, Amanda C Guidon, Bastien Joubert, Jérôme Honnorat
• Journal: The Lancet. Neurology (Lancet Neurol) Vol. 23 Issue 1 Pg. 81-94 (Jan 2024) ISSN: 1474-4465 [Electronic] England
• PMID: 38101905 (Publication Type: Journal Article, Review)
• Copyright: Copyright © 2024 Elsevier Ltd. All rights reserved.

Chemical References

• Immune Checkpoint Inhibitors
• Autoantibodies

Topics

• Humans
• Immune Checkpoint Inhibitors
• Paraneoplastic Syndromes, Nervous System (therapy)
• Paraneoplastic Syndromes
• Neoplasms
• Autoantibodies