Elevated C-Reactive Protein as a Potential Biomarker for Neurological Adverse Events in Immune Checkpoint Inhibitor...

Area of Science:

• Oncology
• Neuroimmunology
• Cancer Therapeutics

Background:

• Immune checkpoint inhibitors (ICIs) have revolutionized cancer treatment since 2011.
• Neurological autoimmune adverse events (nAEs) from ICIs are poorly understood, lacking diagnostic and treatment guidelines.
• These nAEs can lead to severe disability or death.

Purpose of the Study:

• To investigate the incidence and characteristics of neurological adverse events in cancer patients treated with ICIs.
• To identify potential predictive biomarkers for these nAEs.
• To explore patient and treatment-related factors associated with nAE occurrence.

Main Methods:

• A prospective monocentric cohort study included 150 cancer patients treated with ICIs between December 2019 and August 2021.
• Neurological assessments, clinical scores, and side effect severity were analyzed.
• Blood samples were collected throughout therapy, and patients with and without nAEs were compared for potential biomarkers.

Main Results:

• 55 out of 150 patients (36.7%) experienced nAEs, with 3.3% experiencing severe events (Grade ≥ 3), including encephalitis and cerebral vasculitis.
• Elevated C-reactive protein (CRP) within the first 3-4 weeks of therapy was statistically associated with an increased likelihood of nAEs.
• Concurrent chemotherapy was significantly associated with the occurrence of nAEs.

Conclusions:

• The study identified a notable rate of nAEs in ICI-treated patients, influenced by a broad case definition.
• CRP elevation shows promise as a predictive biomarker for nAEs, meriting further research.
• While other markers were statistically significant, they lacked consistent clinical relevance.