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与免疫检查点抑制剂相关的抗体阳性瘤神经综合征:系统性审查

Le Zhang¹, Siyuan Fan¹, Jiawei Wang²

¹Department of Neurology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100730, China.

Journal of neurology

|March 5, 2025

概括

这一系统性审查强调了在接受免疫检查点抑制剂 (ICI) 治疗的患者中抗体阳性神经综合征 (PNS). 边缘脑炎和抗Hu抗体是常见的,高风险抗体与较差的结果有关.

科学领域:

神经免疫学神经免疫学
在瘤学瘤学.
药理学药理学是指药理学的学科.

背景情况:

免疫检查点抑制剂 (ICI) 可以引发与免疫相关的不良事件,包括神经神经瘤综合征 (PNS).
与ICI相关的抗体阳性PNS带来了独特的临床和预后挑战.
了解这些综合征对于及时诊断和管理至关重要.

研究的目的:

在接受ICI的患者中描述抗体阳性PNS的临床特征和预后因素.
为提供关于ICI诱导的神经并发症这一特定子集的全面概述.

主要方法:

在2023年12月之前,对PubMed和Embase数据库进行了系统审查.
包括的研究集中在患有抗神经元抗体的患者和根据2021年PNS-Care Score标准诊断的PNS.
进行了临床表型,自身抗体,治疗方法和结果的数据提取和分析.

主要成果:

确定了108名抗体阳性ICI-PNS患者,其中60.2%被归类为确定的PNS.
边缘脑炎 (35.2%) 和抗胡抗体 (34.3%) 是最常见的.
神经症状通常在ICI治疗6个月内出现;56.3%改善,但37.0%死亡,与更糟糕的预后相关的抗Hu/抗Ma2抗体.

结论:

抗体阳性ICI-PNS经常涉及边缘脑炎和抗Hu抗体,通常与脑脊液炎症有关.
停止ICI和皮质类固醇治疗是主要的治疗方法.
某些抗体,特别是抗Hu和抗Ma2,表明不良结果的风险更高.

关键词:

免疫检查点抑制剂免疫检查点抑制剂神经系统免疫相关的不良事件.麻性神经系统综合征麻性神经系统综合征

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