Neurologic Complications from Immune Checkpoint Inhibitors

Immune checkpoint inhibitors (ICIs) act against factors including cytotoxic T-lymphocyte antigen-4 (CTLA-4), programmed death-1 (PD-1), and programmed death ligand-1 (PD-L1). In addition to the therapeutic effect of ICIs, immune-related adverse events (AEs) may occur. In this review, a single center reports their 6-year experience with neurologic AEs.

Of 1834 patients who received ICIs, 28 (1.5%) had grade III or IV neurologic AEs. Neurologic AEs were most common with combination ICIs, followed by anti-CTLA-4 therapy, and least common with anti-PD therapy. Localization was 39% central nervous system (CNS), 43% peripheral nervous system (PNS), and 18% both. All patients with neurologic AEs had ICIs held or discontinued. Glucocorticoids were s…