Paraneoplastic Sensory Polyneuropathy Related to Anti-PD-L1-including Anticancer Treatment in a Patient with Lung Cancer

Intern Med. 2021 May 15;60(10):1577-1581. doi: 10.2169/internalmedicine.5629-20. Epub 2020 Dec 15.

Abstract

Paraneoplastic neurological syndromes (PNS), such as sensory polyneuropathy, are rare, and serum neuronal antibodies that are used for diagnosing this syndrome are occasionally positive. Similarly, neurological immune-related adverse events due to immune checkpoint inhibitors (ICIs) are also rare. However, their etiologies and the relationship between them remain unclear. We herein report a patient with suspected small cell lung cancer who showed sensory polyneuropathy after treatment with atezolizumab in combination with cytotoxic agents (carboplatin and etoposide) and was doubly positive for serum anti-Hu and anti-SOX-1 antibodies. Treatment with ICI and cytotoxic agents may sometimes lead to the development of PNS.

Keywords: anti-Hu antibody; anti-neuronal antibodies; immune checkpoint inhibitors; paraneoplastic neurological syndrome; sensory polyneuropathy; small cell lung cancer.

Publication types

  • Case Reports

MeSH terms

  • Autoantibodies
  • Carboplatin / adverse effects
  • Humans
  • Lung Neoplasms* / drug therapy
  • Paraneoplastic Polyneuropathy* / chemically induced
  • Paraneoplastic Polyneuropathy* / diagnosis
  • Small Cell Lung Carcinoma* / complications
  • Small Cell Lung Carcinoma* / drug therapy

Substances

  • Autoantibodies
  • Carboplatin