Immune Checkpoint Inhibitor Related Neuropathic Adverse Effects on Cancer Patients

• 作者: Haijun Zhang Samrat Khanal
• 来源期刊: 生物科学与医学(英文)
• 学科: 医学
• 关键词: Immune-Related ADVERSE Events IMMUNE CHECKPOINT Inhibitors Nivolumab IPILIMUMAB Lung Cancer Melanoma
• 年，卷（期）: 2019,（6）
• 页码范围: 1-12
• 页数: 12页
• 分类号: R73

摘要

With the recent development and clinical application, immune checkpoint inhibitors (ICIs) intervention is being increasingly common for multiple malignancies. With these, prospect on focus creates an increasing necessity for an early recognition with proper documentation of upcoming treatment-related toxicities. These treatment-related toxicities are generally termed as immune-related adverse effects (irAEs) [1]. It is a known fact that the upregulation of T-cell initiates autoimmunity resulting in these irAEs. The review focuses on increasing events of neuropathy associated with immunecheckpoint inhibitors, which is one of the rare neurological irAEs, therefore, the least reviewed. The severity and distribution of neurologic toxicities are important deciding factors for its management (CNS vs. PNS), although there is no strong evidence for patients treated with ICIs are specifically affected by the use of immune-modulating interventions. Furthermore, the review discusses on pathophysiology, incidence, clinical presentation, diagnosis, and management of neuropathies as a result of ICIs. Early administration of high-dose corticosteroids is the main management of neuropathies especially for grade 3 or 4 irAEs initial cessation of ICI therapy with continued steroids which are necessary. However, the optimal duration of ICI therapy to minimize the risk of toxicity should be kept under consideration.