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Neuroimmune Crosstalk: Peripheral Nervous System Disorders After Immune Checkpoint Inhibitors
Ayşegül Gündüz1, Merve İriş1, Zeliha Birsin2
1Department of Neurology, Istanbul University-Cerrahpasa, Cerrahpasa Medical Faculty, Istanbul, Türkiye; and.
Journal of Clinical Neuromuscular Disease
|June 2, 2026
Summary
Immune checkpoint inhibitors (ICIs) can cause peripheral nervous system issues, primarily axonal polyneuropathy and myopathy, in cancer patients. Early intervention with immunomodulatory therapy can improve function in affected individuals.
Area of Science:
- Neurology
- Oncology
- Immunology
Background:
- Immune checkpoint inhibitors (ICIs) are increasingly utilized for cancer treatment.
- ICIs can induce immune-related adverse events affecting various organ systems.
- Peripheral nervous system (PNS) complications are a recognized but less understood side effect of ICIs.
Purpose of the Study:
- To determine the incidence and characteristics of PNS involvement in patients treated with ICIs.
- To identify associated clinical features, treatment strategies, and prognosis.
- To understand the spectrum of ICI-related neurological complications.
Main Methods:
- Retrospective cross-sectional study design.
- Inclusion of patients with neurological complaints using ICIs from January 2019 to August 2024.
- Review of medical and electrophysiologic records, extracting demographic, oncologic, and neurological data.
Main Results:
- Prevalence of newly developed PNS involvement was 8% among 31 reviewed patients.
- Most common complications included sensory or sensory-motor axonal polyneuropathy and myopathy.
- Pembrolizumab, nivolumab, and atezolizumab were frequently associated medications; immunomodulatory therapy improved function in nonambulatory patients.
Conclusions:
- Axonal polyneuropathy and myopathy are the predominant PNS complications of ICIs.
- The specific ICI, cancer type, and prior chemotherapy may influence the risk of neurological side effects.
- Further research is warranted to elucidate the mechanisms and optimize management of ICI-induced neuropathy.
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