Universidade de São Paulo, Hospital das Clinicas, Departamento de Neurologia, São Paulo SP, Brazil.
Universidade de São Paulo, Instituto do Câncer do Estado de São Paulo, Departamento de Neurologia, Sao Paulo SP, Brazil.
Arq Neuropsiquiatr. 2022 May;80(5 Suppl 1):270-280. doi: 10.1590/0004-282X-ANP-2022-S116.
Cancer immunotherapy encompasses a wide range of treatment modalities that harness the anti-tumor effects of the immune system and have revolutionized oncological treatment in recent years, with approval for its use in more and more cancers. However, it is not without side effects. Several neurological adverse events have been recognized associated with immune checkpoint inhibitors (ICI) and chimeric antigen receptor (CAR) T-cell therapy, the two main classes of cancer immunotherapy. With the increase in the prevalence of oncological diseases and this type of therapy, it is improbable that neurologists, oncologists, hematologists, and other healthcare professionals who deal with cancer patients will not encounter this type of neurologic complication in their practice in the following years. This article aims to review the epidemiology, clinical manifestations, diagnosis, and management of neurological complications associated with ICI and CAR T-cell therapy.
癌症免疫疗法涵盖了广泛的治疗方式,利用免疫系统的抗肿瘤作用,近年来彻底改变了肿瘤治疗方法,越来越多的癌症获得了免疫疗法的批准。然而,它并非没有副作用。免疫检查点抑制剂(ICI)和嵌合抗原受体(CAR)T 细胞疗法这两种主要的癌症免疫疗法与几种神经不良事件相关。随着肿瘤疾病和这种治疗方法的增加,在未来几年,神经科医生、肿瘤学家、血液学家和其他治疗癌症患者的医疗保健专业人员在实践中很可能会遇到这种类型的神经并发症。本文旨在综述与 ICI 和 CAR T 细胞疗法相关的神经并发症的流行病学、临床表现、诊断和管理。