Immune checkpoint inhibitor-induced neurologic toxicity: a case report and literature review

Area of Science:

• Oncology
• Immunology
• Neurology

Background:

• Immune checkpoint inhibitors (ICIs) are standard treatments for head and neck carcinoma, enhancing patient survival.
• However, ICIs can induce immune-related adverse events (irAEs), which may be severe and impact treatment efficacy.
• Neurologic irAEs (NirAEs) represent a rare but significant category of these adverse events.

Observation:

• This report details a rare case of a neurologic adverse event linked to monotherapy with a programmed death-1 inhibitor.
• Neurologic irAEs manifest in diverse and atypical ways, posing risks of disability.
• These events can arise at any point during or following ICI treatment.

Findings:

• The case highlights the potential for programmed death-1 inhibitor monotherapy to trigger serious neurologic complications.
• Neurologic irAEs require prompt identification and intervention, including drug withdrawal.
• High-dose systemic corticosteroids are commonly recommended, but optimal immunomodulatory strategies remain under investigation.

Implications:

• Early detection and management of NirAEs are critical for mitigating disability and improving patient prognosis in head and neck cancer.
• Further research is needed to define optimal immunomodulatory treatments for managing neurologic immune-related adverse events.
• Understanding and addressing these rare but severe side effects are essential for safe and effective ICI therapy.