Myasthenia Gravis Induced by Immune Checkpoint Inhibitors: An Emerging Neurotoxicity in Neuro-Oncology Practice: Case Series

被引：13

作者：

Marco, Carla ^{[1
,2
]}

Simo, Marta ^{[1
]}

Alemany, Montse ^{[1
]}

Casasnovas, Carlos ^{[2
]}

Dominguez, Raul ^{[2
]}

Vilarino, Noelia ^{[1
,3
]}

Calvo, Mariona ^{[3
]}

Martin-Liberal, Juan ^{[3
]}

Brenes, Jesus ^{[3
]}

Sabater-Riera, Joan ^{[4
]}

Bruna, Jordi ^{[1
,5
]}

Velasco, Roser ^{[1
,2
,5
]}

机构：

[1] Hosp Univ Bellvitge, Hosp Duran & Reynals, Inst Invest Biomed Bellvitge IDIBELL, Neuro Oncol Unit,Catalan Inst Oncol, Lhospitalet De Llobregat 08908, Spain

[2] Hosp Univ Bellvitge, Neurol Dept, Neuromuscular Unit, Lhospitalet De Llobregat 08907, Spain

[3] Hosp Duran & Reynals, Catalan Inst Oncol, Inst Invest Biomed Bellvitge IDIBELL, Dept Oncol, Lhospitalet De Llobregat 08908, Spain

[4] Hosp Univ Bellvitge, Inst Invest Biomed Bellvitge IDIBELL, Crit Care Dept, Lhospitalet De Llobregat 08908, Spain

[5] Inst Neurosci UAB, Dept Cell Biol Physiol & Immunol, Cerdanyola Del Valles 08193, Spain

来源：

JOURNAL OF CLINICAL MEDICINE | 2023年 / 12卷 / 01期

关键词：

myasthenia gravis; immune checkpoint inhibitors; immune-related adverse events; neurotoxicity; neuro-oncology; ADVERSE EVENTS;

D O I：

10.3390/jcm12010130

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Immunotherapy with immune checkpoint inhibitors (ICIs) have been reported to induce de novo or exacerbate pre-existing Myasthenia Gravis (MG). We present a single center case series of patients who developed an immune-related myasthenia gravis (irMG) related with ICIs. We performed a retrospective chart review of the electronic medical records between 1 September 2017 and 2022. We report the clinical features, presentation forms, diagnostic workflows, general management and outcomes of six patients who received ICIs for different solid organ malignancies and developed an irMG frequently overlapping with immune-related myocarditis and/or myositis. The aim of the article is to describe the clinical features, treatment and outcomes of this challenging and potentially life-threating syndrome, comparing our data with those described in the literature. Differences between irMG and classic MG are highlighted.

引用

页数：10

共 37 条

[1] Incidence and characteristics of neurotoxicity in immune checkpoint inhibitors with focus on neuromuscular events: Experience beyond the clinical trials [J].

Bruna, Jordi ;

Argyriou, Andreas A. ;

Anastopoulou, Garifallia G. ;

Alemany, Montse ;

Nadal, Ernest ;

Kalofonou, Foteini ;

Piulats, Josep M. ;

Simo, Marta ;

Velasco, Roser ;

Kalofonos, Haralabos P. .

JOURNAL OF THE PERIPHERAL NERVOUS SYSTEM, 2020, 25 (02) :171-177

[2] Myasthenia Gravis: Epidemiology, Pathophysiology and Clinical Manifestations [J].

Dresser, Laura ;

Wlodarski, Richard ;

Rezania, Kourosh ;

Soliven, Betty .

JOURNAL OF CLINICAL MEDICINE, 2021, 10 (11)

[3] Severe Neurological Toxicity of Immune Checkpoint Inhibitors: Growing Spectrum [J].

Dubey, Divyanshu ;

David, William S. ;

Reynolds, Kerry L. ;

Chute, Donald F. ;

Clement, Nathan F. ;

Cohen, Justine V. ;

Lawrence, Donald P. ;

Mooradian, Meghan J. ;

Sullivan, Ryan J. ;

Guidon, Amanda C. .

ANNALS OF NEUROLOGY, 2020, 87 (05) :659-669

[4] Varied phenotypes and management of immune checkpoint inhibitor-associated neuropathies [J].

Dubey, Divyanshu ;

David, William S. ;

Amato, Anthony A. ;

Reynolds, Kerry L. ;

Clement, Nathan F. ;

Chute, Donald F. ;

Cohen, Justine V. ;

Lawrence, Donald P. ;

Mooradian, Meghan J. ;

Sullivan, Ryan J. ;

Guidon, Amanda C. .

NEUROLOGY, 2019, 93 (11) :E1093-E1103

[5] FDA approves anti-LAG3 checkpoint [J].

Eisenstein, Michael .

NATURE BIOTECHNOLOGY, 2022, 40 (05) :625-625

[6] Neurologic complications of immune checkpoint inhibitors [J].

Fellner, Avi ;

Makranz, Chen ;

Lotem, Michal ;

Bokstein, Felix ;

Taliansky, Alisa ;

Rosenberg, Shai ;

Blumenthal, Deborah T. ;

Mandel, Jacob ;

Fichman, Suzana ;

Kogan, Elena ;

Steiner, Israel ;

Siegal, Tali ;

Lossos, Alexander ;

Yust-Katz, Shlomit .

JOURNAL OF NEURO-ONCOLOGY, 2018, 137 (03) :601-609

[7] Using the Common Terminology Criteria for Adverse Events (CTCAE - Version 5.0) to Evaluate the Severity of Adverse Events of Anticancer Therapies [J].

Freites-Martinez, A. ;

Santana, N. ;

Arias-Santiago, S. ;

Viera, A. .

ACTAS DERMO-SIFILIOGRAFICAS, 2021, 112 (01) :90-92

[8] Original Research Late-onset and long-lasting immune-related adverse events from immune checkpoint-inhibitors: An overlooked aspect in immunotherapy [J].

Ghisoni, E. ;

Wicky, A. ;

Bouchaab, H. ;

Imbimbo, M. ;

Delyon, J. ;

Moura, B. Gautron ;

Gerard, C. L. ;

Latifyan, S. ;

Ozdemir, B. C. ;

Caikovski, M. ;

Pradervand, S. ;

Tavazzi, E. ;

Gatta, R. ;

Marandino, L. ;

Valabrega, G. ;

Aglietta, M. ;

Obeid, M. ;

Homicsko, K. ;

Alfonso, N. N. Mederos ;

Zimmermann, S. ;

Coukos, G. ;

Peters, S. ;

Cuendet, M. A. ;

Di Maio, M. ;

Michielin, O. .

EUROPEAN JOURNAL OF CANCER, 2021, 149 :153-164

[9] Myasthenia Gravis [J].

Gilhus, Nils E. .

NEW ENGLAND JOURNAL OF MEDICINE, 2016, 375 (26) :2570-2581

[10] Consensus disease definitions for neurologic immune-related adverse events of immune checkpoint inhibitors [J].

Guidon, Amanda C. ;

Burton, Leeann B. ;

Chwalisz, Bart K. ;

Hillis, James ;

Schaller, Teilo H. ;

Amato, Anthony A. ;

Warner, Allison Betof ;

Brastianos, Priscilla K. ;

Cho, Tracey A. ;

Clardy, Stacey L. ;

Cohen, Justine, V ;

Dietrich, Jorg ;

Dougan, Michael ;

Doughty, Christopher T. ;

Dubey, Divyanshu ;

Gelfand, Jeffrey M. ;

Guptill, Jeffrey T. ;

Johnson, Douglas B. ;

Juel, Vern C. ;

Kadish, Robert ;

Kolb, Noah ;

LeBoeuf, Nicole R. ;

Linnoila, Jenny ;

Mammen, Andrew L. ;

Martinez-Lage, Maria ;

Mooradian, Meghan J. ;

Naidoo, Jarushka ;

Neilan, Tomas G. ;

Reardon, David A. ;

Rubin, Krista M. ;

Santomasso, Bianca D. ;

Sullivan, Ryan J. ;

Wang, Nancy ;

Woodman, Karin ;

Zubiri, Leyre ;

Louv, William C. ;

Reynolds, Kerry L. .

JOURNAL FOR IMMUNOTHERAPY OF CANCER, 2021, 9 (07)

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