Patterns of neurological adverse events among a retrospective cohort of patients receiving immune checkpoint inhibitors

Immunotherapy. 2024 Apr;16(6):381-390. doi: 10.2217/imt-2023-0273. Epub 2024 Jan 10.

Abstract

Aim: Neurological adverse events (NAEs) are infrequent immune checkpoint inhibitor (ICI) outcomes poorly characterized in extant research, complicating their clinical management. Methods: This study characterized the frequency, severity, patterning and timing of NAEs using a large retrospective registry, including all patients who received at least one dose of an ICI from 2/1/2011-4/7/2022 within our health network. Results: Among 3137 patients, there were 54 NAEs (1.72% any grade; 0.8% grade 3-4). Most NAEs were peripheral (57.4%) versus central (42.6%). Melanoma and renal cell carcinoma were significantly associated with NAEs. Conclusion: The incidence of NAEs was rare though higher than many prior case estimates; the timing was consistent with other AEs. NAEs frequently occurred in tumor types known to favor brain metastases.

Keywords: brain metastasis; central nervous system; immune checkpoint inhibitors; incidence; melanoma; neurological adverse events; peripheral nervous system; renal cell carcinoma.

Plain language summary

Immune checkpoint inhibitors are new drugs for cancer. They boost your body's defenses to fight cancer cells. These drugs can be used alone or with other cancer treatments. Most people are okay with these medicines, but some might have problems in different parts of the body. This can be tricky to figure out. Rarely, there can be issues in the brain or nerves. These side effects are rare, happening in about 2 in every 100 people who use the drugs. They are more common in certain cancers like melanoma and kidney cancer. As doctors learn more about these side effects, they can better predict, treat, and prevent them.

MeSH terms

  • Brain Neoplasms*
  • Carcinoma, Renal Cell* / drug therapy
  • Humans
  • Immune Checkpoint Inhibitors / adverse effects
  • Kidney Neoplasms*
  • Retrospective Studies

Substances

  • Immune Checkpoint Inhibitors