Abstract Details

Title Immune Checkpoint Inhibitor use in Patients with Pre-existing Neurological Autoimmune Diseases: A Case Series

Topic General Neurology

Presentation(s) General Neurology Posters (7:00 AM-5:00 PM)

Poster/Presentation
Number 097

Objective Examine the safety of immune-checkpoint inhibitor use in patients with pre-existing neurological autoimmune conditions and explore the unique clinical considerations for this patient population.

Background

Pre-existing autoimmune conditions were initially perceived as contraindications for immune checkpoint inhibitor therapy for advanced malignancies. Since these patients were excluded from clinical trials, there is little data regarding the safety and efficacy of immune checkpoint inhibitors in this patient population.

Design/Methods This retrospective case-series study included 5 patients who had been diagnosed with a neurological autoimmune disease prior to receiving immune checkpoint inhibitor therapy for advanced malignancy. Patient charts were reviewed to determine outcomes with regard to their malignancy, exacerbation of their underlying autoimmune disease and occurrence of any other immune-related adverse events.

Results Of patients treated with immune checkpoint inhibitors, two had prior diagnosis of myasthenia gravis, two of Guillain-Barre Syndrome and one of chronic idiopathic demyelinating polyneuropathy. Three patients entered partial or complete cancer remission while receiving immune checkpoint inhibitor therapy. One patient experienced a flare of their neurological autoimmune disease while receiving an immune checkpoint inhibitor and four of the five patients experienced immune-related adverse events unrelated to their neurological autoimmune disease.

Conclusions In this case-series study, patients with pre-existing neurological autoimmune disease showed varied responses to immune checkpoint inhibitor therapy with regard to cancer remission and neurological autoimmune disease flare. However, as a whole, exacerbations of neurological autoimmune disease symptoms were less common and less severe than those existing case reports. Further research is needed to determine what factors influence an individual’s risk of neurological autoimmune disease complication while receiving immune checkpoint inhibitor therapy.

Authors/Disclosures
Andrew R. Snavely PRESENTER	Mr. Snavely has nothing to disclose.
Sujata P. Thawani, MD (NYU Neurology Associates)	Dr. Thawani has nothing to disclose.
	No disclosure on file

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