PD-1 Checkpoint Inhibitor Associated Autoimmune Encephalitis.

Abstract

OBJECTIVE:

To report first-hand narrative experience of autoimmune encephalitis and to briefly review currently available evidence of autoimmune encephalitis in cancer patients treated with immune checkpoint inhibitors.

SETTING:

A case study is presented on the management of a patient who developed autoimmune encephalitis during nivolumab monotherapy occurring after 28 weeks on anti-PD-1 monotherapy (nivolumab 3 mg/kg every 2 weeks) for non-small cell lung cancer.

RESULTS:

No substantial improvement was observed by antiepileptic treatment. After administration of 80 mg methylprednisolone, neurologic symptoms disappeared within 24 h and the patient fully recovered.

CONCLUSIONS:

Immune checkpoint inhibitor treatment can lead to autoimmune encephalitis. Clinical trial data indicate a frequency of autoimmune encephalitis of ≥0.1 to <1% with a higher probability during combined or sequential anti-CTLA-4/anti-PD-1 therapy than during anti-PD-1 or anti-PD-L1 monotherapy. Further collection of evidence and translational research is warranted.

• Authors: Stephanie Schneider, Silke Potthast, Paul Komminoth, Guido Schwegler, Steffen Böhm
• Journal: Case reports in oncology (Case Rep Oncol) 2017 May-Aug Vol. 10 Issue 2 Pg. 473-478 ISSN: 1662-6575 [Print] Switzerland
• PMID: 28626408 (Publication Type: Case Reports)