Neurological complications of anti-programmed death 1 antibodies

• 出 处: 中华物理医学与康复杂志
• 发表日期: 2017年39期

BACKGROUND AND OBJECTIVE

Neurologic complications have been recognized for many cancer interventions, including anti-programmed death 1 antibodies (PD-1), used for the treatment of solid organ tumors. This study was designed to better understand the frequency, phenotypes and severity of complications when using this intervention.

METHODS

Subjects were identified through the Mayo Cancer Pharmacy Database in Rochester, Minnesota, for patients receiving anti-PD-1 monoclonal antibodies (pembrolizumab or nivolumab). From this list the authors identified those who developed neurologic disorders after treatment, excluding those who developed neurologic symptoms attributable to their disease or other treatments. All subjects were assessed with the modified Rankin Scale score and with electrodiagnostic testing.

RESULTS

Of the 347 patients, 10 were identified with neurological complications related to the treatment (2.9%). Neuromuscular disorders were the most common of the complications, including myopathy (two) and neuropathy (four). In addition, there were single cases of cerebellar ataxia, autoimmune retinopathy, bilateral internuclear ophthalmoplegia and headache. The complications occurred after a median of 5.5 cycles of the medicine. Nine patients improved, including one spontaneous improvement and eight with immune rescue treatment, most often using high-dose prednisone.

CONCLUSION

This retrospective study identified neurologic adverse events among 2.9% of patients treated with anti-PD-1 therapy.