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1 Multiple Sclerosis Center, Department of Neurology, Division of Neuroimmunology, Columbia University Vagelos College of Physicians and Surgeons, Columbia University Irving Medical Center-New York Presbyterian Hospital, 710 W 168th Street, Neurological Institute, New York, NY 10032, USA.
2 Department of Neurology, Division of Neuro-Oncology, Columbia University Vagelos College of Physicians and Surgeons, Herbert Irving Comprehensive Cancer Center, New York-Presbyterian Hospital, New York, NY 10032, USA.
3 Program in Neuroinfectious Diseases and Related Disorders, Division of Critical Care and Hospitalist Neurology, Columbia University Irving Medical Center-New York Presbyterian Hospital, New York, NY 10032, USA.
1 Multiple Sclerosis Center, Department of Neurology, Division of Neuroimmunology, Columbia University Vagelos College of Physicians and Surgeons, Columbia University Irving Medical Center-New York Presbyterian Hospital, 710 W 168th Street, Neurological Institute, New York, NY 10032, USA.
2 Department of Neurology, Division of Neuro-Oncology, Columbia University Vagelos College of Physicians and Surgeons, Herbert Irving Comprehensive Cancer Center, New York-Presbyterian Hospital, New York, NY 10032, USA.
3 Program in Neuroinfectious Diseases and Related Disorders, Division of Critical Care and Hospitalist Neurology, Columbia University Irving Medical Center-New York Presbyterian Hospital, New York, NY 10032, USA.
The emergence of immune-based treatments for cancer has led to a growing field dedicated to understanding and managing iatrogenic immunotoxicities that arise from these agents. Immune-related adverse events (irAEs) can develop as isolated events or as toxicities affecting multiple body systems. In particular, this review details the neurological irAEs from immune checkpoint inhibitors (ICI) and chimeric antigen receptor (CAR) T cell immunotherapies. The recognition and treatment of neurological irAEs has variable success, depending on the severity and nature of the neurological involvement. Understanding the involved mechanisms, predicting those at higher risk for irAEs, and establishing safety parameters for resuming cancer immunotherapies after irAEs are all important fields of ongoing research.
Robert C. A decade of immune-checkpoint inhibitors in cancer therapy. Nat. Commun. 2020;11:3801. doi: 10.1038/s41467-020-17670-y.
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Schubert M.L., Schmitt M., Wang L., Ramos C.A., Jordan K., Tidow C.-M., Dreger P. Side-effect management of chimeric antigen receptor (CAR) T-cell therapy. Ann. Oncol. 2021;32:34–48. doi: 10.1016/j.annonc.2020.10.478.
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Ramos-Casals M., Brahmer J.R., Callahan M.K., Flores-Chávez A., Keegan N., Khamashta M.A., Lambotte O., Mariette X., Prat A., Suárez-Almazor M.E. Immune-related adverse events of checkpoint inhibitors. Nat. Rev. Dis. Primers. 2020;6:38. doi: 10.1038/s41572-020-0160-6.
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Santomasso B., Bachier C., Westin J., Rezvani K., Shpall E.J. The Other Side of CAR T-Cell Therapy: Cytokine Release Syndrome, Neurologic Toxicity, and Financial Burden. Am. Soc. Clin. Oncol. Educ. Book. 2019;39:433–444. doi: 10.1200/EDBK_238691.
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Gettings E.J., Hackett C.T., Scott T.F. Severe relapse in a multiple sclerosis patient associated with ipilimumab treatment of melanoma: Clinical and Laboratory Research. Mult. Scler. J. 2015;21:670. doi: 10.1177/1352458514549403.
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