| アブストラクト | INTRODUCTION: Neurological immune-related adverse events are a rare but potentially deadly complication after immune checkpoint inhibitor (ICI) treatment. As multiple sclerosis (MS) is an immune-mediated disease, it is unknown how ICI treatment may affect outcomes. METHODS: We analyzed the United States Food and Drug Administration (FDA) Adverse Event Reporting System (FAERS) database for pembrolizumab, atezolizumab, nivolumab, ipilimumab, avelumab, and durvalumab 2 years prior their FDA approval until December 31, 2017, to include all cases with confirmed diagnosis/relapse of MS. We also included cases reported in the literature and a patient from our institution. RESULTS: We identified 14 cases of MS with median age of presentation of 52 years. Indications for ICI included melanoma in 7 (36.36%) cases, non-small cell lung carcinoma in 2 (18.18%) cases, 1 case (9.09%) each of pleural mesothelioma, renal cell carcinoma, and colorectal cancer, and unreported in 2 (18.18%) cases. History of MS was confirmed in 8 (57.1%) cases. Median time to beginning of symptoms was 29 days with rapid disease progression; two patients died due to their relapse. Median time for symptom resolution was 8 weeks. Outcomes did not vary by comparing CTLA-4 and PD-1/PD-L1 inhibitors. CONCLUSIONS: Reported MS relapses after ICI are rare, but the adverse events described include rapid neurologic progression and death. Larger and prospective studies are warranted to assess disability and long-term outcomes and outweigh the risks of starting immunotherapy in patients with MS. |
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| ジャーナル名 | Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico |
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| 投稿日 | 2019/2/23 |
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| 投稿者 | Garcia, Catherine R; Jayswal, Rani; Adams, Val; Anthony, Lowell B; Villano, John L |
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| 組織名 | Markey Cancer Center, University of Kentucky, 800 Rose Street, CC446, Lexington,;KY, 40536-0293, USA.;Department of Clinical Oncology Pharmacy, University of Kentucky, Lexington, USA.;Department of Internal Medicine, Medical Oncology, University of Kentucky,;Lexington, USA.;Lexington, USA. jlvillano@uky.edu.;Department of Neurology, University of Kentucky, Lexington, USA.;jlvillano@uky.edu.;Department of Neurosurgery, University of Kentucky, Lexington, USA.;KY, 40536-0293, USA. jlvillano@uky.edu. |
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| Pubmed リンク | https://www.ncbi.nlm.nih.gov/pubmed/30788836/ |
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