Immune checkpoint inhibitor-induced encephalitis with dostarlimab in two patients: Case series
Immune checkpoint inhibitors (ICIs) are being used increasingly in the treatment of several cancers and have been associated with neurological complications including immune checkpoint inhibitor-induced encephalitis (ICI-iE). We present two cases of ICI-iE with the novel agent dostarlimab, which to...
| Main Authors: | , |
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| Format: | Article |
| Language: | English |
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Elsevier
2021-12-01
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| Series: | eNeurologicalSci |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2405650221000484 |
| _version_ | 1831643342176256000 |
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| author | Sina Marzoughi Tychicus Chen |
| author_facet | Sina Marzoughi Tychicus Chen |
| author_sort | Sina Marzoughi |
| collection | DOAJ |
| description | Immune checkpoint inhibitors (ICIs) are being used increasingly in the treatment of several cancers and have been associated with neurological complications including immune checkpoint inhibitor-induced encephalitis (ICI-iE). We present two cases of ICI-iE with the novel agent dostarlimab, which to our knowledge are the first reported with this agent. These cases add to the growing body of literature on ICI-iE, demonstrating two cases of meningoencephalitis associated with the novel agent dostarlimab treated successfully with prednisone. As imaging studies may be unrevealing, clinicians must maintain a high index of suspicion for ICI-iE in any patient who develops altered mental status on ICI therapy, with low threshold to obtain lumbar puncture for evidence of inflammatory CSF and to exclude other causes. It is important to note that many neurological presentations of ICIs can also be secondary to tumor metastasis and other paraneoplastic syndromes, making the diagnosis challenging. Prognosis can be good with early recognition and treatment with corticosteroids. Whether patients can be rechallenged with ICI is to be determined in larger studies given the rarity of this complication. |
| first_indexed | 2024-12-19T12:58:11Z |
| format | Article |
| id | doaj.art-6859ab9da819467ebe63348d9bd9ba50 |
| institution | Directory Open Access Journal |
| issn | 2405-6502 |
| language | English |
| last_indexed | 2024-12-19T12:58:11Z |
| publishDate | 2021-12-01 |
| publisher | Elsevier |
| record_format | Article |
| series | eNeurologicalSci |
| spelling | doaj.art-6859ab9da819467ebe63348d9bd9ba502022-12-21T20:20:20ZengElseviereNeurologicalSci2405-65022021-12-0125100356Immune checkpoint inhibitor-induced encephalitis with dostarlimab in two patients: Case seriesSina Marzoughi0Tychicus Chen1Corresponding author.; University of British Columbia, Department of Medicine, Division of Neurology, 8219-2775 Laurel St., Vancouver, BC V5Z 1M9, CanadaUniversity of British Columbia, Department of Medicine, Division of Neurology, 8219-2775 Laurel St., Vancouver, BC V5Z 1M9, CanadaImmune checkpoint inhibitors (ICIs) are being used increasingly in the treatment of several cancers and have been associated with neurological complications including immune checkpoint inhibitor-induced encephalitis (ICI-iE). We present two cases of ICI-iE with the novel agent dostarlimab, which to our knowledge are the first reported with this agent. These cases add to the growing body of literature on ICI-iE, demonstrating two cases of meningoencephalitis associated with the novel agent dostarlimab treated successfully with prednisone. As imaging studies may be unrevealing, clinicians must maintain a high index of suspicion for ICI-iE in any patient who develops altered mental status on ICI therapy, with low threshold to obtain lumbar puncture for evidence of inflammatory CSF and to exclude other causes. It is important to note that many neurological presentations of ICIs can also be secondary to tumor metastasis and other paraneoplastic syndromes, making the diagnosis challenging. Prognosis can be good with early recognition and treatment with corticosteroids. Whether patients can be rechallenged with ICI is to be determined in larger studies given the rarity of this complication.http://www.sciencedirect.com/science/article/pii/S2405650221000484NeuroimmunologyDostarlimabEncephalitisCheck-point inhibitor |
| spellingShingle | Sina Marzoughi Tychicus Chen Immune checkpoint inhibitor-induced encephalitis with dostarlimab in two patients: Case series eNeurologicalSci Neuroimmunology Dostarlimab Encephalitis Check-point inhibitor |
| title | Immune checkpoint inhibitor-induced encephalitis with dostarlimab in two patients: Case series |
| title_full | Immune checkpoint inhibitor-induced encephalitis with dostarlimab in two patients: Case series |
| title_fullStr | Immune checkpoint inhibitor-induced encephalitis with dostarlimab in two patients: Case series |
| title_full_unstemmed | Immune checkpoint inhibitor-induced encephalitis with dostarlimab in two patients: Case series |
| title_short | Immune checkpoint inhibitor-induced encephalitis with dostarlimab in two patients: Case series |
| title_sort | immune checkpoint inhibitor induced encephalitis with dostarlimab in two patients case series |
| topic | Neuroimmunology Dostarlimab Encephalitis Check-point inhibitor |
| url | http://www.sciencedirect.com/science/article/pii/S2405650221000484 |
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