Neurologic Complications of Immunotherapy

Immunotherapy enhances a patient's own immune system to fight against malignancy and has become increasingly popular during the last decade. Tumor cells can escape destruction by the patient's immune system by overexpression of immunosuppressive molecules such as cytotoxic T-lymphocyte-associated antigen-4 (CTLA-4), programmed cell death-1 (PD-1) receptor, and its ligand PD-L1. Immunotherapy agents target these inhibitors and basically reactivate the cytotoxic lymphocytes to destroy the tumor cells. Immunotherapy agents currently are FDA-approved for advanced malignancies including melanoma, Hodgkin lymphoma, head and neck squamous cell carcinoma, non-small cell lung cancer, and renal cell carcinoma. In addition, they have shown beneficial promise in the treatment of other malignancies such as high-grade gliomas.1 As of 2018, the common immune checkpoint blocking antibodies approved by the FDA for immunotherapy include ipilimumab, nivolumab, and pembrolizumab; however, exponential growth of these agents is expected in the next few years when many new agents will receive approval and cover a wider range of malignancies. Considering that immunotherapy seeks to harness the patient's own immune system to fight cancer, increased inflammatory changes are expected. The inflammatory changes may involve the skin, gastrointestinal tract, liver, endocrine, and neurologic systems and together are known as immune-related adverse events (irAEs).
Source: Contemporary Diagnostic Radiology - Category: Radiology Tags: ARTICLE Source Type: research