Neurological Adverse Effects of Immune Checkpoint Inhibitors and Chimeric Antigen Receptor T-Cell Therapy

Area of Science:

• Oncology
• Immunology
• Neurology

Background:

• Immune checkpoint inhibitors (ICPIs) and chimeric antigen receptor (CAR) T-cell therapies are novel treatments for various cancers.
• These immunotherapies modulate the immune system, leading to potential immune-related adverse events (irAEs).
• Neurological complications are uncommon but can significantly impact treatment course and patient outcomes.

Purpose of the Study:

• To review the neurological side effects associated with ICPIs and CAR T-cell therapies.
• To highlight the spectrum of central and peripheral nervous system complications.
• To emphasize the importance of early diagnosis and management of these irAEs.

Main Methods:

• Literature review of neurological complications from ICPIs and CAR T-cell therapies.
• Analysis of reported cases involving peripheral and central nervous system involvement.
• Synthesis of current understanding of irAEs in neuro-oncology and immunotherapy.

Main Results:

• Neurological irAEs include polyneuropathy, myositis, myasthenia gravis, demyelinating polyradiculopathy, myelitis, and encephalitis.
• These complications affect both the peripheral and central nervous systems.
• Prompt recognition and treatment with steroids can mitigate short-term and long-term adverse effects.

Conclusions:

• Neurological irAEs are a critical consideration in patients receiving ICPIs and CAR T-cell therapies.
• Early identification and intervention with corticosteroids are essential for managing neurotoxicity.
• Optimizing patient outcomes requires vigilant monitoring and timely management of these immune-related neurological events.