PD-1 Checkpoint Inhibitor Associated Autoimmune Encephalitis

Case Rep Oncol. 2017 May 24;10(2):473-478. doi: 10.1159/000477162. eCollection 2017 May-Aug.

Abstract

Objective: To report first-hand narrative experience of autoimmune encephalitis and to briefly review currently available evidence of autoimmune encephalitis in cancer patients treated with immune checkpoint inhibitors.

Setting: A case study is presented on the management of a patient who developed autoimmune encephalitis during nivolumab monotherapy occurring after 28 weeks on anti-PD-1 monotherapy (nivolumab 3 mg/kg every 2 weeks) for non-small cell lung cancer.

Results: No substantial improvement was observed by antiepileptic treatment. After administration of 80 mg methylprednisolone, neurologic symptoms disappeared within 24 h and the patient fully recovered.

Conclusions: Immune checkpoint inhibitor treatment can lead to autoimmune encephalitis. Clinical trial data indicate a frequency of autoimmune encephalitis of ≥0.1 to <1% with a higher probability during combined or sequential anti-CTLA-4/anti-PD-1 therapy than during anti-PD-1 or anti-PD-L1 monotherapy. Further collection of evidence and translational research is warranted.

Keywords: Adverse event; Autoimmune encephalitis; Checkpoint inhibitor; Nivolumab; Non-small cell lung cancer; PD-1.

Publication types

  • Case Reports