AUTHOR=Ruggiero Rosanna , Balzano Nunzia , Di Napoli Raffaella , Fraenza Federica , Pentella Ciro , Riccardi Consiglia , Donniacuo Maria , Tesorone Marina , Danesi Romano , Del Re Marzia , Rossi Francesco , Capuano Annalisa 

TITLE=Do peripheral neuropathies differ among immune checkpoint inhibitors? Reports from the European post-marketing surveillance database in the past 10 years

JOURNAL=Frontiers in Immunology

VOLUME=Volume 14 - 2023

YEAR=2023

URL=https://www.frontiersin.org/journals/immunology/articles/10.3389/fimmu.2023.1134436

DOI=10.3389/fimmu.2023.1134436

ISSN=1664-3224

ABSTRACT=Although the immunotherapy advent has revolutionized cancer treatments, unfortunately it does not spare cancer patients from possible immune related adverse events (irAEs), which can involve also the peripheral nervous system. The immune checkpoint inhibitors (ICIs), blocking cytotoxic T-lymphocyte-associated protein 4 (CTLA-4), programmed cell death protein 1 (PD-1), or programmed cell death ligand 1 (PD-L1), can induce immune imbalance, causing different peripheral neuropathies (PNs). Considering the wide range of PNs and their high impact on safety and quality of life for the cancer patients and, still, the availability of large post-marketing survaillance databases, we choose to analyse the features of ICI-related PNs emerging from 2010-2020 by ICI-use in the European real-world context.	 
We analyzed data collected in the European post-marketing surveillance, Eudravigilance, conducting a systematic and a disproportional analyses.	
In our study, we found a total of 766 reports describing PNs occurred in 735 patients treated with ICIs. Among them, Guillain Barré syndrome, Miller Fisher syndrome, as well as neuritis, chronic inflammatory demyelinating polyradiculoneuropathy emerged. These ADRs were frequently serious, inducing patients’ disability or hospitalization. Moreover, from our disproportional analysis emerged an increased reporting frequency of PNs with atezolizumab compared to other ICIs. 
Guillain Barré syndrome is a possible PN related to ICIs worthy of note, since it resulted associated to significant impact on safety patient, and with unfavourable outcomes, including the fatal one. The continuous survaillance of the safety profile of ICIs in real life settings results necessary, especially considering the increased frequency emerged in reporting of PNs associated to atezolizumab compared with other ICIs.