A systematic review of immune checkpoint inhibitor-related neurological adverse events and association with anti-neuronal autoantibodies

Expert Opin Biol Ther. 2021 Sep;21(9):1237-1251. doi: 10.1080/14712598.2021.1897101. Epub 2021 Apr 16.

Abstract

Introduction: Immune checkpoint inhibitors (ICI) therapy has led to a paradigm shift in cancer drug development and in the clinical evaluation of approaches to combination cancer treatment. Dysregulation of the immune system by ICI therapy may also elicit autoimmune phenomena and consequently manifest clinically as immune-related adverse events (irAEs) including neurological irAEs. Areas Covered: The purpose of this review is to explore the role of autoantibodies in the diagnosis and prediction of neurological irAEs and to evaluate their pathogenicity. We searched Pubmed and Embase for neurological irAEs and associated autoantibodies and found 28 patients with central and peripheral neurological irAEs. Of these patients, up to 40% had encephalitis, 34.4% with myasthenia gravis and 22% of patients with peripheral neuropathy and Guillain-Barre Syndrome had autoantibodies. Expert Opinion: Overall, our survey suggested a causal relationship between neurological irAEs and autoantibodies. Detection of autoantibodies may help to diagnose neurological irAEs and inform their clinical management.

Keywords: Autoantibodies; encephalitis; guillain-Barre syndrome; immune checkpoint inhibitors; myasthenia gravis; neurological immune related adverse events; neuromuscular disorders; peripheral neuropathy; radiculopathy.

Publication types

  • Systematic Review

MeSH terms

  • Autoantibodies
  • Guillain-Barre Syndrome*
  • Humans
  • Immune Checkpoint Inhibitors
  • Myasthenia Gravis*
  • Neoplasms* / drug therapy

Substances

  • Autoantibodies
  • Immune Checkpoint Inhibitors