Neurotoxicity in the era of immune checkpoint inhibitors: a case-cased approach

Abstract

Immune checkpoint inhibitors (ICIs) have transformed the field of cancer immunotherapy and led to substantial improvements in patient outcomes across various malignancies. Neurological toxicities arising from ICI treatment represent a heterogeneous group of complications that manifest across a broad spectrum, ranging from mild symptoms to life-threatening conditions. The present article reviews patients receiving ICI treatment and identifies neurological adverse events observed across all ICI therapeutic modalities. Data were retrospectively evaluated from 500 cancer patients who received immunotherapy treatment between 2020-2022 at Koç University Hospital Medical Oncology Outpatient Clinic. Eight patients (1.6%) who developed immunotherapy-related neurologic side effects were included in the analysis. Demographic and clinicopathologic characteristics, along with laboratory results, were extracted from the medical oncology outpatient clinic database. In this study, 89% (7/8) of the patients were male, with a median age of 59 years (range 44-79). The most common cancer types observed were small cell lung cancer (n=2) and renal cell carcinoma (n=2). A case study is also presented of a patient who developed neurotoxicity following immunotherapy. Immunotherapy emergence has marked substantial advancement in cancer treatment approaches, although neurological side effects require close monitoring. Recognition of diverse neurological complications associated with ICIs and their potential severity remains essential for clinical practice.