Immune checkpoint inhibitors-related nervous system adverse events

doi:10.3969/j.issn.1672-6731.2022.09.002

Abstract

Abstract: Immune checkpoint inhibitors (ICIs) have been widely used in tumor treatment. Immune-related adverse events (irAEs) are common in skin, endocrine, gastrointestinal tract, liver and cardiovascular system symptoms. Nervous system adverse events are relatively rare, but the clinical presentations are various and difficult to identify. Neurologists should strengthen their understanding of neurologic immune-related adverse events (NirAEs), so as to enable the events to be identified in time, intervene as early as possible, and closely monitor the events, in order to improve the disease prognosis.

Key words: Neoplasms, Immunosuppressive agents, Drug-related side effects and adverse reactions, Nervous system, Review

摘要： 免疫检查点抑制剂广泛用于肿瘤的治疗，与其相关的药物不良反应以皮肤、内分泌、胃肠道、肝脏和心血管系统症状常见，神经系统不良反应虽相对少见，但种类、表现多样，不易识别。了解免疫检查点抑制剂相关神经系统不良反应的发生机制，有助于提高对其认知程度，尽早识别、准确诊断、及时干预、严密监控，最大程度改善患者预后。

关键词: 肿瘤, 免疫抑制剂, 药物相关性副作用和不良反应, 神经系统, 综述

WANG Ze-yi, LIU Guang-zhi. Immune checkpoint inhibitors-related nervous system adverse events[J]. Chinese Journal of Contemporary Neurology and Neurosurgery, 2022, 22(9): 752-756.

王泽祎, 刘广志. 免疫检查点抑制剂相关神经系统不良反应[J]. 中国现代神经疾病杂志, 2022, 22(9): 752-756.

/ / Recommend / Download Citations

URL: https://journal11.magtechjournal.com/cjcnn/EN/10.3969/j.issn.1672-6731.2022.09.002

https://journal11.magtechjournal.com/cjcnn/EN/Y2022/V22/I9/752

References

[1] Haugh AM, Probasco JC, Johnson DB.Neurologic complications of immune checkpoint inhibitors[J].Expert Opin Drug Saf, 2020, 19:479-488.
[2] Anderson D, Beecher G, Nathoo N, Smylie M, McCombe JA, Walker J, Jassal R.Proposed diagnostic and treatment paradigm for high-grade neurological complications of immune checkpoint inhibitors[J].Neurooncol Pract, 2019, 6:340-345.
[3] Haslam A, Prasad V.Estimation of the percentage of US patients with cancer who are eligible for and respond to checkpoint inhibitor immunotherapy drugs[J].JAMA Netw Open, 2019, 2:e192535.
[4] Vogrig A, Muñiz-Castrillo S, Farina A, Honnorat J, Joubert B.How to diagnose and manage neurological toxicities of immune checkpoint inhibitors:an update[J].J Neurol, 2022, 269:1701-1714.
[5] Marini A, Bernardini A, Gigli GL, Valente M, Muñiz-Castrillo S, Honnorat J, Vogrig A.Neurologic adverse events of immune checkpoint inhibitors:a systematic review[J].Neurology, 2021, 96:754-766.
[6] Schneider BJ, Naidoo J, Santomasso BD, Lacchetti C, Adkins S, Anadkat M, Atkins MB, Brassil KJ, Caterino JM, Chau I, Davies MJ, Ernstoff MS, Fecher L, Ghosh M, Jaiyesimi I, Mammen JS, Naing A, Nastoupil LJ, Phillips T, Porter LD, Reichner CA, Seigel C, Song JM, Spira A, Suarez-Almazor M, Swami U, Thompson JA, Vikas P, Wang Y, Weber JS, Funchain P, Bollin K.Management of immune-related adverse events in patients treated with immune checkpoint inhibitor therapy:ASCO guideline update[J].J Clin Oncol, 2021, 39:4073-4126.
[7] Möhn N, Beutel G, Gutzmer R, Ivanyi P, Satzger I, Skripuletz T.Neurological immune related adverse events associated with nivolumab, ipilimumab, and pembrolizumab therapy-review of the literature and future outlook[J].J Clin Med, 2019, 8:1777.
[8] Guidon AC, Burton LB, Chwalisz BK, Hillis J, Schaller TH, Amato AA, Betof Warner A, Brastianos PK, Cho TA, Clardy SL, Cohen JV, Dietrich J, Dougan M, Doughty CT, Dubey D, Gelfand JM, Guptill JT, Johnson DB, Juel VC, Kadish R, Kolb N, LeBoeuf NR, Linnoila J, Mammen AL, Martinez-Lage M, Mooradian MJ, Naidoo J, Neilan TG, Reardon DA, Rubin KM, Santomasso BD, Sullivan RJ, Wang N, Woodman K, Zubiri L, Louv WC, Reynolds KL.Consensus disease definitions for neurologic immune-related adverse events of immune checkpoint inhibitors[J].J Immunother Cancer, 2021, 9:e002890.
[9] Li C, Zhao ZG.Pharmaceutical care and neurological adverse reactions associated with PD-1 inhibitors[J].Zhong Nan Yao Xue, 2021, 19:548-552.[李草, 赵志刚.程序性死亡受体1抑制剂的神经系统不良反应及药学监护[J].中南药学, 2021, 19:548-552.]
[10] Johnson DB, Nebhan CA, Moslehi JJ, Balko JM.Immune-checkpoint inhibitors:long-term implications of toxicity[J].Nat Rev Clin Oncol, 2022, 19:254-267.
[11] Albarrán V, Chamorro J, Rosero DI, Saavedra C, Soria A, Carrato A, Gajate P.Neurologic toxicity of immune checkpoint inhibitors:a review of literature[J].Front Pharmacol, 2022, 13:774170.
[12] Willsmore ZN, Harris RJ, Crescioli S, Hussein K, Kakkassery H, Thapa D, Cheung A, Chauhan J, Bax HJ, Chenoweth A, Laddach R, Osborn G, McCraw A, Hoffmann RM, Nakamura M, Geh JL, MacKenzie-Ross A, Healy C, Tsoka S, Spicer JF, Papa S, Barber L, Lacy KE, Karagiannis SN.B cells in patients with melanoma:implications for treatment with checkpoint inhibitor antibodies[J].Front Immunol, 2021, 11:622442.
[13] Das R, Bar N, Ferreira M, Newman AM, Zhang L, Bailur JK, Bacchiocchi A, Kluger H, Wei W, Halaban R, Sznol M, Dhodapkar MV, Dhodapkar KM.Early B cell changes predict autoimmunity following combination immune checkpoint blockade[J].J Clin Invest, 2018, 128:715-720.
[14] König D, Läubli H.Mechanisms of immune-related complications in cancer patients treated with immune checkpoint inhibitors[J].Pharmacology, 2021, 106:123-136.
[15] Schumacher TN, Thommen DS.Tertiary lymphoid structures in cancer[J].Science, 2022, 375:eabf9419.
[16] Jain V, Remley W, Bunag C, Elfasi A, Chuquilin M.Rituximab in refractory myositis and acute neuropathy secondary to checkpoint inhibitor therapy[J].Cureus, 2022, 14:e25129.
[17] Reynolds KL, Guidon AC.Diagnosis and management of immune checkpoint inhibitor-associated neurologic toxicity:illustrative case and review of the literature[J].Oncologist, 2019, 24:435-443.
[18] Chennamadhavuni A, Abushahin L, Jin N, Presley CJ, Manne A.Risk factors and biomarkers for immune-related adverse events:a practical guide to identifying high-risk patients and rechallenging immune checkpoint inhibitors[J].Front Immunol, 2022, 13:779691.
[19] Brahmer JR, Lacchetti C, Schneider BJ, Atkins MB, Brassil KJ, Caterino JM, Chau I, Ernstoff MS, Gardner JM, Ginex P, Hallmeyer S, Holter Chakrabarty J, Leighl NB, Mammen JS, McDermott DF, Naing A, Nastoupil LJ, Phillips T, Porter LD, Puzanov I, Reichner CA, Santomasso BD, Seigel C, Spira A, Suarez-Almazor ME, Wang Y, Weber JS, Wolchok JD, Thompson JA; National Comprehensive Cancer Network.Management of immune-related adverse events in patients treated with immune checkpoint inhibitor therapy:American Society of Clinical Oncology Clinical Practice Guideline[J].J Clin Oncol, 2018, 36:1714-1768.
[20] Deftereos SN, Georgonikou D.Effectiveness of rituximab in treating immune-checkpoint-inhibitor-induced immune-related adverse events:results of a systematic review[J].Ann Oncol, 2021, 32:282-283.
[21] Ding XJ, Chen D, Tang C, Yao Y.Advance of immune checkpoint inhibitors and clinical trials in glioma[J].Zhongguo Xian Dai Shen Jing Ji Bing Za Zhi, 2020, 20:96-104.[丁骁杰, 陈弟, 唐超, 姚瑜.脑胶质瘤免疫检查点抑制剂及其临床研究进展[J].中国现代神经疾病杂志, 2020, 20:96-104.]
[22] Zhang YM, Yu SP, Liu PD, Li T, Zhang L, Xie Y, Li JB, Zhang JH, Fan XG, Yang XJ.Regulation of tumor immunity by metabolism of glioma cells and immune cells in tumor microenvironment[J].Zhongguo Xian Dai Shen Jing Ji Bing Za Zhi, 2020, 20:73-78.[张一鸣, 于圣平, 刘沛东, 李涛, 张亮, 解杨, 李佳博, 张锦浩, 樊晓光, 杨学军.肿瘤微环境中胶质瘤细胞和免疫细胞代谢对抗肿瘤免疫的调控作用[J].中国现代神经疾病杂志, 2020, 20:73-78.]
[23] Zhao Q, Zhang J, Xu L, Yang H, Liang N, Zhang L, Zhang F, Zhang X.Safety and efficacy of the rechallenge of immune checkpoint inhibitors after immune-related adverse events in patients with cancer:a systemic review and meta-analysis[J].Front Immunol, 2021, 12:730320.

Please choose a citation manager

Content to export