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CASE REPORT article

Front. Oncol.
Sec. Cancer Immunity and Immunotherapy
Volume 14 - 2024 | doi: 10.3389/fonc.2024.1404829
This article is part of the Research Topic Investigating tumor immunotherapy responses in lung cancer using deep learning View all 6 articles

Immune Checkpoint Inhibitor-induced Paraneoplastic Neurological Syndrome in Two Patients: A Case Series

Provisionally accepted
Guang-Qing Shi Guang-Qing Shi 1Heng-Ning Lian Heng-Ning Lian 2Huan Wang Huan Wang 1Jie-Qiang Xia Jie-Qiang Xia 3Li-Jie Ma Li-Jie Ma 1Jing Zhou Jing Zhou 4*
  • 1 Department of Respiratory and Critical Care Medicine, General Hospital of Western Theater Command, Chengdu,China, Chengdu, China
  • 2 Department of Respiratory and Critical Care Medicine, General Hospital of Western Theater Command, chengdu, China
  • 3 The First People’s Hospital of Shuangliu District, Chengdu, Chengdu, Sichuan Province, China
  • 4 Department of Respiratory and Critical Care Medicine, Western Theater General Hospital, Chengdu, China

The final, formatted version of the article will be published soon.

    Immune checkpoint inhibitors (ICIs) combined with chemotherapy have improved overall survival in patients with smallcell lung cancer, but have also led to an increase in adverse effects. The incidence of ICI-induced paraneoplastic neurological syndrome (PNS) is relatively low when the primary lung lesion is well controlled. However, it is associated with high mortality and disability rates. In this report, we present two cases of extensive-stage small-cell lung cancer with neurological symptoms and positive paraneoplastic antibodies in the serum and cerebrospinal fluid (CSF) following ICI therapy. Although the symptoms improved after treatment with systemic high-dose immunoglobulin and glucocorticoids, one patient, unfortunately, succumbed to tumor progression four months later, whereas the other patient experienced persistent difficulty in standing and walking despite improved muscle strength. In cases where neurological symptoms that cannot be explained by tumor metastases arise during ICI treatment, paraneoplastic syndromes should be considered and testing for antineuronal antibodies is crucial, as early detection and intervention can help mitigate their impact.Further research is needed to develop better predictive strategies and treatment protocols for these adverse reactions.

    Keywords: Anti-γ-aminobutyric acid B receptor antibody, Anti-Hu antibody, immune checkpoint inhibitors, durvalumab, adebrelimab, Paraneoplastic neurological syndrome

    Received: 21 Mar 2024; Accepted: 09 Oct 2024.

    Copyright: © 2024 Shi, Lian, Wang, Xia, Ma and Zhou. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Jing Zhou, Department of Respiratory and Critical Care Medicine, Western Theater General Hospital, Chengdu, China

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