Neuromuscular complications of immune checkpoint inhibitors - 03/12/18

Doi : 10.1016/j.lpm.2018.10.009

Dimitri Psimaras ^1,^2,^⁎
¹ Sorbonne université, Inserm, CNRS, UMR S 1127, institut du cerveau et de la moelle épinière, ICM, AP-HP, hôpitaux universitaires La Pitié Salpêtrière - Charles Foix, service de neurologie 2-Mazarin, 75013 Paris, France
² OncoNeuroTox Group, Center for Patients with Neurological Complications of Oncologic Treatments, Hôpitaux Universitaires Pitié-Salpetrière-Charles Foix et Hôpital Percy, 75013 Paris, France

^⁎Dimitri Psimaras, Sorbonne université, Inserm, CNRS, UMR S 1127, institut du cerveau et de la moelle épinière, ICM, AP-HP, hôpitaux universitaires La Pitié Salpêtrière - Charles Foix, service de neurologie 2-Mazarin, 75013 Paris, France.Sorbonne université, Inserm, CNRS, UMR S 1127, institut du cerveau et de la moelle épinière, ICM, AP-HP, hôpitaux universitaires La Pitié Salpêtrière - Charles Foix, service de neurologie 2-Mazarin Paris75013France

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Highlights

•	Neurological irAE are very uncommon in cancer patients with ICIs treatment, in less than 3% of the patients, but with potentially poor outcome.
•	ICI-associated myositis with or without myasthenia gravis are the more frequent complications and respond well to corticosteroid therapy and ICIs discontinuation.
•	Oculobulbar involvement is unique and common among patients with ICI-associated myositis.
•	Myocarditis is occasionally associated in irMyositis and consists with diaphragm disorder pejoratives prognostic factors.

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Summary

Immune checkpoint inhibitors have been increasingly used in patients with various cancers. Despite favourable oncological outcomes these treatments have also been associated with immune-related adverse events. Neurological irAE are rare but potentially severe and neuromuscular complications are the most common. This is a new group of neurologic complications of systemic anticancer therapies, often responsive to immune-modulating therapies. Early recognition and treatment are crucial for timely improvement of functional outcome and requires a multidisciplinary approach.

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