دورية أكاديمية
Immune Checkpoint Inhibitor-related Guillain-Barré Syndrome: A Case Series and Review of the Literature.
العنوان: | Immune Checkpoint Inhibitor-related Guillain-Barré Syndrome: A Case Series and Review of the Literature. |
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المؤلفون: | Janssen JBE; Departments of Medical Oncology., Leow TYS; Departments of Medical Oncology., Herbschleb KH; Department of Internal Medicine, St. Antonius Ziekenhuis, Nieuwegein, The Netherlands., Gijtenbeek JMM; Neurology, Radboud University Medical Center., Boers-Sonderen MJ; Departments of Medical Oncology., Gerritsen WR; Departments of Medical Oncology.; Department of Tumor Immunology, Radboud Institute for Molecular Life Sciences, Radboud University Medical Center, Nijmegen., Westdorp H; Departments of Medical Oncology.; Department of Tumor Immunology, Radboud Institute for Molecular Life Sciences, Radboud University Medical Center, Nijmegen. |
المصدر: | Journal of immunotherapy (Hagerstown, Md. : 1997) [J Immunother] 2021 Sep 01; Vol. 44 (7), pp. 276-282. |
نوع المنشور: | Case Reports; Journal Article; Review |
اللغة: | English |
بيانات الدورية: | Publisher: Lippincott Williams & Wilkins Country of Publication: United States NLM ID: 9706083 Publication Model: Print Cited Medium: Internet ISSN: 1537-4513 (Electronic) Linking ISSN: 15249557 NLM ISO Abbreviation: J Immunother Subsets: MEDLINE |
أسماء مطبوعة: | Publication: Hagerstown, MD : Lippincott Williams & Wilkins Original Publication: Hagerstown, MD : Lippincott-Raven, c1997- |
مواضيع طبية MeSH: | Antibodies, Monoclonal, Humanized/*adverse effects , Guillain-Barre Syndrome/*chemically induced , Immune Checkpoint Inhibitors/*adverse effects , Nivolumab/*adverse effects, Aged ; Fatal Outcome ; Guillain-Barre Syndrome/drug therapy ; Humans ; Immunoglobulins, Intravenous/therapeutic use ; Male ; Melanoma/drug therapy ; Middle Aged ; Prednisolone/therapeutic use ; Prostatic Neoplasms, Castration-Resistant/drug therapy |
مستخلص: | Immune checkpoint inhibitors (ICIs) have been approved for the treatment of various malignancies with promising clinical outcomes. Treatment can, however, be accompanied by serious immune-related adverse events. Neurological adverse events like Guillain-Barré syndrome (GBS) are rare but potentially life-threatening. We present 3 cases of ICI-related GBS; review cases described in current literature, and discuss treatment strategies. Three patients developed GBS after ICI treatment. The first case with pembrolizumab had a fatal outcome despite treatment with multiple regimens, including steroids and intravenous immunoglobulin (IVIg). The other 2 cases with nivolumab-induced and pembrolizumab-induced GBS, respectively, responded well to treatment with IVIg and steroids. In the current literature, a total of 31 other cases were found. Treatment for ICI-related GBS mostly consisted of concurrent IVIg and steroids (44%), which led to clinical improvement in 73%. Most patients recovered with remaining symptoms (68%), while 10 patients developed respiratory failure (29%) and 6 patients (18%) died. ICI-related GBS should be suspected in patients on ICI treatment who develop subacute progressive weakness of the limbs, sensory loss, and areflexia. On the basis of the guidelines recommendations and our review of the literature, we advise first-line therapy with concurrent IVIg 0.4 g/kg/d for 5 days and prednisolone 1-2 mg/kg/d. Discontinuation of immunotherapy after ICI-related GBS is advised. (Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.) |
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المشرفين على المادة: | 0 (Antibodies, Monoclonal, Humanized) 0 (Immune Checkpoint Inhibitors) 0 (Immunoglobulins, Intravenous) 31YO63LBSN (Nivolumab) 9PHQ9Y1OLM (Prednisolone) DPT0O3T46P (pembrolizumab) |
تواريخ الأحداث: | Date Created: 20210324 Date Completed: 20220321 Latest Revision: 20230901 |
رمز التحديث: | 20230902 |
DOI: | 10.1097/CJI.0000000000000364 |
PMID: | 33758147 |
قاعدة البيانات: | MEDLINE |
تدمد: | 1537-4513 |
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DOI: | 10.1097/CJI.0000000000000364 |