Neurological Immunotoxicity from Cancer Treatment

Int J Mol Sci. 2021 Jun 23;22(13):6716. doi: 10.3390/ijms22136716.

Abstract

The emergence of immune-based treatments for cancer has led to a growing field dedicated to understanding and managing iatrogenic immunotoxicities that arise from these agents. Immune-related adverse events (irAEs) can develop as isolated events or as toxicities affecting multiple body systems. In particular, this review details the neurological irAEs from immune checkpoint inhibitors (ICI) and chimeric antigen receptor (CAR) T cell immunotherapies. The recognition and treatment of neurological irAEs has variable success, depending on the severity and nature of the neurological involvement. Understanding the involved mechanisms, predicting those at higher risk for irAEs, and establishing safety parameters for resuming cancer immunotherapies after irAEs are all important fields of ongoing research.

Keywords: checkpoint inhibitors; chimeric antigen receptor T-cell therapies; immune-related adverse events; neurotoxicity.

Publication types

  • Review

MeSH terms

  • Biomarkers, Pharmacological / analysis
  • Biomarkers, Tumor / analysis
  • CTLA-4 Antigen / antagonists & inhibitors
  • Encephalitis / chemically induced
  • Humans
  • Immune Checkpoint Inhibitors / adverse effects*
  • Immune Checkpoint Inhibitors / therapeutic use
  • Immunotherapy / adverse effects*
  • Immunotherapy, Adoptive / adverse effects*
  • Immunotherapy, Adoptive / methods
  • Meningitis, Aseptic / chemically induced
  • Meningitis, Aseptic / immunology
  • Neoplasms / immunology
  • Neoplasms / therapy*
  • Paraneoplastic Syndromes / chemically induced
  • Receptors, Chimeric Antigen / therapeutic use
  • T-Lymphocytes / drug effects
  • T-Lymphocytes / immunology

Substances

  • Biomarkers, Pharmacological
  • Biomarkers, Tumor
  • CTLA-4 Antigen
  • CTLA4 protein, human
  • Immune Checkpoint Inhibitors
  • Receptors, Chimeric Antigen