Journal Article (Review Article)

DZNE-2022-00186

http://join2-wiki.gsi.de/foswiki/pub/Main/Artwork/join2_logo100x88.png Paraneoplastic Autoimmune Neurological Syndromes and the Role of Immune Checkpoint Inhibitors.

Duong, S. L. (First author)DZNE* ; Prüß, H. (Last author)DZNE*

2022
Springer New York, NY

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Please use a persistent id in citations: doi:10.1007/s13311-022-01184-0

Abstract: The introduction of immune checkpoint inhibitors (ICIs) in oncologic therapies has led to a paradigm shift in cancer treatment. ICIs have increased the overall survival in patients with malignant melanoma, small-cell lung cancer, and many other tumor entities. Despite their clinical benefits, these novel cancer immunotherapies can induce neurological immune-related adverse events (irAEs). Such immune-mediated complications can manifest within the spectrum of paraneoplastic neurological syndromes (PNSs). PNSs are rare immune-mediated complications of systemic cancers that can involve every aspect of the nervous system. The emergence of PNSs with ICI treatment opens further pathways to study the complex immunopathological interplay of cancer immunity, cross-reactive neurological autoimmune phenomena, and effects of ICIs on the immune system. ICI-induced PNSs comprise a diverse antibody repertoire and phenotypic spectrum with severe and life-threatening disease progression in some cases. Timely diagnosis and urgent interventions are pivotal for a favorable neurologic and oncologic outcome. This review focuses on the pathogenesis of cancer immunotherapy and the disruption of immune tolerance in PNSs and provides an overview of the most pertinent clinical manifestations and principles of diagnostic and therapeutic managements in light of the expected increase in PNSs due to the widespread use of ICIs in clinical practice. This review further discusses potential and evolving concepts of therapeutic monoclonal antibodies for the treatment of PNSs.

Keyword(s): Antineoplastic Agents, Immunological: adverse effects (MeSH) ; Humans (MeSH) ; Immune Checkpoint Inhibitors (MeSH) ; Immunotherapy: adverse effects (MeSH) ; Immunotherapy: methods (MeSH) ; Melanoma: chemically induced (MeSH) ; Syndrome (MeSH) ; Autoantibodies ; Biologicals ; Immune checkpoint inhibitors ; Neurological adverse events ; Novel immunotherapies ; Paraneoplastic neurological syndromes

Note: (CC BY)

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Contributing Institute(s):

1. Clinical Study Team Berlin Priller (Clinical Study Team Berlin 1)
2. Autoimmune Enzephalopathies (AG Prüß)

Research Program(s):

1. 353 - Clinical and Health Care Research (POF4-353) (POF4-353)

Appears in the scientific report 2022

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Database coverage:
; ; ; Clarivate Analytics Master Journal List ; Current Contents - Clinical Medicine ; Current Contents - Life Sciences ; DEAL Springer ; Essential Science Indicators ; IF >= 5 ; JCR ; SCOPUS ; Science Citation Index Expanded ; Web of Science Core Collection

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