Evaluation and management of acute high-grade immunotherapy-related neurotoxicity

Sandoval, Marcelo; Wechsler, Adriana H.; Alhajji, Zahra; Viets-Upchurch, Jayne; Brock, Patricia; Lipe, Demis N.; Al-Buraiki, Aisha; Yeung, Sai Ching Jim

doi:10.1016/j.heliyon.2023.e13725

Cited by 2 publications

(1 citation statement)

References 172 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…GBS is a group of autoimmune disorders manifested by acute polyradiculoneuropathy, and it is the most common cause of acute flaccid paralysis [ 6 ]. ICI-associated GBS is seen in 0.1%-0.3% of all patients receiving ICIs [ 19 ]. It has mostly been observed with the combination therapy of ipilimumab and nivolumab [ 20 ].…”

Section: Discussionmentioning

confidence: 99%

Immune Checkpoint Inhibitor-Induced Guillain Barre Syndrome: A Single-Institution Case Report and Narrative Review

Idogun,

Hafez-Khayyata,

Ezekwudo

2024

Cureus

View full text Add to dashboard Cite

Guillain-Barré syndrome (GBS) resulting from the use of immune checkpoint inhibitors (ICIs) is relatively uncommon but has been reported. Herein, we discuss a case of a 67-year-old patient who received neoadjuvant ICI for treatment of non-small cell lung cancer and then presented with lower extremity weakness and areflexia, progressing to respiratory muscle and upper extremity weakness. Given the increasing use of ICI in cancer management, awareness of neurological autoimmune side effects is essential. ICI-mediated GBS can be severe and fatal if not diagnosed promptly. We discuss a case of ICI-induced GBS and review literature on current management approaches.

show abstract

Section: Discussionmentioning

confidence: 99%

Immune Checkpoint Inhibitor-Induced Guillain Barre Syndrome: A Single-Institution Case Report and Narrative Review

Idogun,

Hafez-Khayyata,

Ezekwudo

2024

Cureus

View full text Add to dashboard Cite

show abstract

Chemotherapy‐Induced Neuropathy Affecting the Gastrointestinal Tract

Vera,

Nurgali,

Abalo

2024

Neurogastroenterology Motil

View full text Add to dashboard Cite

BackgroundCancer is a major global cause of morbidity and mortality. Survivorship is increasing, bringing new challenges. Cancer treatment, including chemotherapeutic drugs, immunotherapy, and radiotherapy, can have severe and impactful gastrointestinal side effects occurring shortly after treatment (acute toxicity) or persisting for years after treatment ends (late/chronic toxicity).PurposeThe aim of this article is to review the neurotoxic effects of chemotherapy on the enteric nervous system (ENS) and the gut extrinsic innervation. These effects could contribute to the development of long‐term gastrointestinal dysfunctions. Research, primarily conducted in animal models, indicates that antitumoral drugs can lead to chemotherapy‐induced enteric neuropathy (CIEN). Studies, mainly performed in the myenteric plexus, show that CIEN is characterized by a reduced density of nerve cells and fibers, as well as an imbalanced representation of neuronal subpopulations or their markers, with enteric glial cells also affected.These alterations underlie changes in neuronal activity and gastrointestinal motor function. Although research on the submucosal plexus remains limited, evidence suggests that CIEN affects the entire ENS. Furthermore, scarce studies show that CIEN also occurs in humans. Moreover, emerging experimental data on chemotherapy‐induced alterations in visceral sensitivity suggest that the extrinsic innervation of the gut is also affected, but this has received little attention thus far. Nevertheless, this could contribute to the development of chemotherapy‐induced brain–gut axis (BGA) disorders in the long term. Cancer chemotherapy (and probably also immunotherapy and radiotherapy) seems to cause neuropathic effects on the intrinsic and extrinsic innervation of the gastrointestinal tract, with an important impact on gastrointestinal and BGA functions. This is a relatively neglected area deserving further investigation.

show abstract

Evaluation and management of acute high-grade immunotherapy-related neurotoxicity

Cited by 2 publications

References 172 publications

Immune Checkpoint Inhibitor-Induced Guillain Barre Syndrome: A Single-Institution Case Report and Narrative Review

Immune Checkpoint Inhibitor-Induced Guillain Barre Syndrome: A Single-Institution Case Report and Narrative Review

Chemotherapy‐Induced Neuropathy Affecting the Gastrointestinal Tract

Contact Info

Product

Resources

About