1. Severe Neurological Toxicity of Immune Checkpoint Inhibitors: Growing Spectrum
- Author
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Meghan J. Mooradian, Donald F. Chute, William S. David, Ryan J. Sullivan, Donald P. Lawrence, Divyanshu Dubey, Nathan F. Clement, Kerry L. Reynolds, Amanda C. Guidon, and Justine V. Cohen
- Subjects
0301 basic medicine ,medicine.medical_specialty ,Combination therapy ,business.industry ,Immune checkpoint inhibitors ,MEDLINE ,Tertiary care ,03 medical and health sciences ,030104 developmental biology ,0302 clinical medicine ,Neurology ,Toxicity ,medicine ,Neurology (clinical) ,Relapse risk ,Intensive care medicine ,business ,Adverse effect ,030217 neurology & neurosurgery - Abstract
Expanding use of immune-checkpoint inhibitors (ICIs) underscores the importance of accurate diagnosis and timely management of neurological immune-related adverse events (irAE-N). We evaluate the real-world frequency, phenotypes, co-occurring immune-related adverse events (irAEs), and long-term outcomes of severe, grade III to V irAE-N at a tertiary care center over 6 years. We analyze how our experience supports published literature and professional society guidelines. We also discuss these data with regard to common clinical scenarios, such as combination therapy, ICI rechallenge and risk of relapse of irAE-N, and corticosteroid taper, which are not specifically addressed by current guidelines and/or have limited data. Recommendations for management and future irAE-N reporting are outlined. ANN NEUROL 2020;87:659-669.
- Published
- 2020
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