TY - JOUR
T1 - Neuromuscular adverse events
AU - Suzuki, Shigeaki
N1 - Publisher Copyright:
© 2018 Japanese Journal of Cancer and Chemotherapy Publishers Inc. All Rights Reserved.
PY - 2018/7
Y1 - 2018/7
N2 - Neuromuscular adverse events (AEs) associated with cancer treatment with immune checkpoint inhibitors (ICIs) include diverse clinical subsets. The general features of neuromuscular AEs have not been elucidated because the frequency is generally low, ranging from 1-2% of cancer patients undergoing ICIs therapy. The diseases affect the central nervous system, peripheral nerves, neuromuscular junction, and muscle. Disease onset and progression may be rapid with a critical clinical course. The clinical presentation may be different from that of patients unrelated to drugs. Headache, dizziness, and dysgeusia were relatively common and mild treatment-related AEs. In contrast, representative immune-related AEs such as autoimmune encephalitis, demyelinating polyneuropathy, myasthenia, and myositis were serious. There was a tight association between myasthenia, myositis, and myocarditis. There are guidelines for the treatment of neuromuscular immune-mediated AEs. For all but the minimum neurological symptoms, checkpoint inhibitor therapy should be withheld until the nature of the AEs is defined. Immune-modulating medication is generally effective for neuromuscular AEs. Both CD8+ cytotoxic T-cells and autoantibodies are involved in the pathogenesis of neuromuscular AEs. Correct understanding of neuromuscular AEs is required for the best management of cancer patients.
AB - Neuromuscular adverse events (AEs) associated with cancer treatment with immune checkpoint inhibitors (ICIs) include diverse clinical subsets. The general features of neuromuscular AEs have not been elucidated because the frequency is generally low, ranging from 1-2% of cancer patients undergoing ICIs therapy. The diseases affect the central nervous system, peripheral nerves, neuromuscular junction, and muscle. Disease onset and progression may be rapid with a critical clinical course. The clinical presentation may be different from that of patients unrelated to drugs. Headache, dizziness, and dysgeusia were relatively common and mild treatment-related AEs. In contrast, representative immune-related AEs such as autoimmune encephalitis, demyelinating polyneuropathy, myasthenia, and myositis were serious. There was a tight association between myasthenia, myositis, and myocarditis. There are guidelines for the treatment of neuromuscular immune-mediated AEs. For all but the minimum neurological symptoms, checkpoint inhibitor therapy should be withheld until the nature of the AEs is defined. Immune-modulating medication is generally effective for neuromuscular AEs. Both CD8+ cytotoxic T-cells and autoantibodies are involved in the pathogenesis of neuromuscular AEs. Correct understanding of neuromuscular AEs is required for the best management of cancer patients.
KW - Immune checkpoint inhibitors
KW - Immune-related adverse events
KW - Myasthenia gravis
KW - Myositis
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M3 - Article
C2 - 30042267
AN - SCOPUS:85053015276
VL - 45
SP - 1036
EP - 1040
JO - Japanese Journal of Cancer and Chemotherapy
JF - Japanese Journal of Cancer and Chemotherapy
SN - 0385-0684
IS - 7
ER -