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Myasthenia Gravis After Nivolumab Therapy for Squamous Cell Carcinoma of the Bladder
Elaine Chang1, Anita L Sabichi, Yvonne H Sada
1*Department of Medicine, Section of Hematology Oncology, Baylor College of Medicine, Houston, TX †Department of Hematology and Oncology at Michael E. DeBakey Veterans Affairs Medical Center, Houston, Texas.
Abstract:
Checkpoint inhibitors have become standard therapy for multiple cancers, and their use will increase in the next year as regulatory approvals for additional indications are expected. It is essential for clinicians to be aware of the potential for rare immune-related adverse effects. Here, we report the case of a new diagnosis of myasthenia gravis (MG) after the use of nivolumab for squamous cell carcinoma of the bladder. A review the literature identified 10 cases of MG diagnosed after programmed cell death protein 1 inhibitor therapy. This is the first case, to our knowledge, reported in association with bladder cancer. The precise diagnosis of MG has important implications on management, as treatment with steroids can transiently worsen myasthenia in nearly 50% of cases.
Insights
Checkpoint inhibitors like nivolumab can cause rare immune-related adverse effects. This report details a new diagnosis of myasthenia gravis (MG) after nivolumab treatment for bladder cancer, highlighting crucial management considerations.
Area of Science:
- Oncology
- Immunology
- Neurology
Background:
- Checkpoint inhibitors, including PD-1 inhibitors like nivolumab, are increasingly used for cancer treatment.
- Immune-related adverse events (irAEs) are known complications of these therapies.
- Rare neurological irAEs require careful monitoring and awareness.
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