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Updated: Oct 29, 2025

Using 22C3 Anti-PD-L1 Antibody Concentrate on Biopsy and Cytology Samples from Non-small Cell Lung Cancer Patients
07:43

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Enteric plexus neuropathy associated with PD-L1 blockade in a patient with small-cell lung cancer

Ioannis P Trontzas1, Vasiliki E Rapti1, Nikolaos K Syrigos1

  • 13rd Department of Internal Medicine, Oncology Unit, Sotiria General Hospital, Athens School of Medicine, 11527, Greece.

Immunotherapy
|July 12, 2021
PubMed

Insights

Immune checkpoint inhibitors can cause rare, severe nervous system side effects. This case highlights a potentially fatal intestinal issue from PD-L1 blockade in lung cancer patients.

Area of Science:

  • Oncology
  • Neuroimmunology
  • Gastroenterology

Background:

  • Immune checkpoint inhibitors (ICIs) have transformed cancer treatment.
  • Increasing ICI use reveals diverse, potentially severe immune-related adverse events (irAEs).
  • Nervous system irAEs are uncommon but critical to recognize.

Observation:

  • Immune-related autonomic neuropathy presents with varied symptoms, including gastrointestinal and cardiovascular issues.
  • Intestinal pseudo-obstruction due to immune-related myenteric autonomic neuropathy is under-recognized.
  • A unique case of enteric plexus neuropathy induced by PD-L1 blockade is presented.

Findings:

  • PD-L1 blockade can induce enteric plexus neuropathy, leading to intestinal pseudo-obstruction.
  • This rare irAE is potentially fatal if not promptly identified and managed.
  • Early diagnosis and intervention are crucial for patient outcomes.

Implications:

  • Clinicians should consider enteric plexus neuropathy in patients on PD-L1 inhibitors presenting with gastrointestinal dysmotility.
  • Further research is needed to understand the mechanisms and optimal management of ICI-induced autonomic neuropathies.
  • This case underscores the importance of vigilance for rare irAEs in the evolving landscape of cancer immunotherapy.
Keywords:
PD-L1autonomic neuropathyenteric plexusimmune checkpoint inhibitorsintestinal pseudo-obstructionirAEs

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