Neurologic Toxicities of Immunotherapy

被引:1
|
作者
Harrison, Rebecca A. [1 ]
Majd, Nazanin K. [1 ]
Tummala, Sudhakar [1 ]
de Groot, John F. [1 ]
机构
[1] Univ Texas MD Anderson, Dept Neurooncol, Houston, TX 77030 USA
来源
IMMUNOTHERAPY, 4TH EDITION | 2021年 / 1342卷
关键词
Immunotherapy; Neurotoxicity; Myasthenia gravis; Myositis; Encephalitis; Checkpoint inihibitor; CAR T cell therapy; Immune effector cell-associated neurotoxicity; T-CELL THERAPY; MYASTHENIA-GRAVIS; ADVERSE EVENTS; AUTOIMMUNE ENCEPHALITIS; CNS DEMYELINATION; IPILIMUMAB; NIVOLUMAB; PATIENT; MELANOMA; PEMBROLIZUMAB;
D O I
10.1007/978-3-030-79308-1_18
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Immunotherapy has revolutionized treatment of cancer over the past two decades. The antitumor effects of immunotherapy approaches are at the expense of growing spectrum of immune-related adverse events (irAEs) due to cross-reactivity between the tumor and normal host tissue. These adverse events can happen in any organ and range from mild to severe and even life-threatening conditions. While neurological irAEs associated with immune checkpoint inhibitors (CPIs) are rare, they pose a significant challenge in management as the clinical phenotypes are heterogenous and frequently necessitate cessation of therapy and systemic immune suppression and lead to transient functional decline. On the other hand, immune effector cell-associated neurotoxicity (ICANS) is common, frequently occurs in conjunction with cytokine release syndrome (CRS), and poses a significant clinical challenge to the development and widespread use of these effective therapies. Early recognition of these neurological syndromes, timely diagnosis, and thoughtful management are key for further clinical development of these effective therapies in cancer patients. Here, we describe clinical phenotypes of CPI-induced neurological complications and ICANS and discuss steps in clinical monitoring, diagnosis, and effective management.
引用
收藏
页码:417 / 429
页数:13
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