Mania as a possible complication of immunotherapy

Mavrotas, Myrto; Murray, Brian

doi:10.1002/pnp.555

Cited by 2 publications

(1 citation statement)

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“…The patient suffered from metabolic acidosis and hypophosphatemia and improved after receiving treatment with intravenous bicarbonate and high-dose steroids. A case of acute mania reported by Mavrotas et al occurred in an elderly female patient with no psychiatric history, exhibiting extensive symmetric leukoencephalopathy on MRI, suggesting an unusually rapid change and resistance to treatment [45]. She initially exhibited symptoms such as pyrexia, agitation, and confusion, and despite the administration of antipsychotic drugs, later displayed hostility, irritability, and persecutory delusions.…”

Section: Combination Therapy With Other Immune Checkpoint Inhibitorsmentioning

confidence: 98%

Uncommon Adverse Events of Immune Checkpoint Inhibitors in Small Cell Lung Cancer: A Systematic Review of Case Reports

Lee,

Jang,

Yang

2024

Cancers

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Background: This study aimed to systematically review case reports documenting rare adverse events in patients with small cell lung cancer (SCLC) following the administration of immune checkpoint inhibitors (ICIs). Methods: A systematic literature review was conducted to identify case reports detailing previously unreported adverse drug reactions to ICIs in patients with SCLC. The scope of the literature reviewed was restricted to case studies on SCLC published up to 31 December 2023. Results: We analyzed twenty-four studies on ICI use for patients with SCLC. There were six reports on atezolizumab, four on durvalumab, and three on adverse events from monotherapy with nivolumab. Reports involving combination treatments were the most frequent, with a total of six, predominantly involving using nivolumab in combination with ipilimumab. Additionally, there was one report each on using pembrolizumab, nofazinilimab, sintilimab, tislelizumab, and toripalimab. We collected detailed information on the clinical course, including patient and disease characteristics, symptoms, treatment for each adverse event, and recovery status. Among the patients included in the case reports, 21 out of 24 (87.5%) had extensive-stage SCLC when initiating ICI therapy, with only 1 patient diagnosed with limited-stage SCLC. Respiratory system adverse events were most common, with seven cases, followed by neurological, endocrinological, and gastroenterological events. Three case reports documented adverse events across multiple systems in a single patient. In most cases, patients showed symptom improvement; however, four studies reported cases where patients either expired without symptom improvement or experienced sequelae. Conclusions: Efforts to develop reliable biomarkers for predicting irAEs continue, with ongoing research to enhance predictive precision. Immunotherapy presents diverse and unpredictable adverse events, underscoring the need for advanced diagnostic tools and a multidisciplinary approach to improve patient management.

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Section: Combination Therapy With Other Immune Checkpoint Inhibitorsmentioning

confidence: 98%