(i) To evaluate the value of a self-questionnaire in screening for neurological complications related to immunological checkpoint inhibitors. (ii) To investigate whether, apart from the subacute complications described in the literature, neurological complications of more insidious onset can occur.

Immunological checkpoint inhibitors (ICI) have led to a therapeutic revolution in the management of many cancers and indications are increasing. Toxicity of these treatments can be severe dysimmune manifestations. Neurological complications are rare, subacute and seem to have a presentation profile quite distinct from that of toxicities related to anticancer chemotherapy, although it is possible that some manifestations remain under-reported or misdiagnosed. 

Patients followed in dermatology department for skin cancers and treated with ICI completed every month a neurological screening auto-questionnaire. Patients were selected for a neurological expertise based on the data from the questionnaires.

149 patients completed a total of 229 questionnaires between July 2019 and December 2019. Of these, 38 patients were identified for a neurological consultation, and none of the patients consulted had a neurological event per se attributable to ICI. Five patients presented rapid tumoral progression in CNS with neurological impairment. During the follow-up, only one patient had a neurological event related to ICI after 6 months of treatment, and this event was not revealed by the questionnaire completed few weeks before.

Neurological signs in ICI-treated-skin-cancer context is more often due to tumoral progression. Neurological complications of ICI remain rare and unpredictable. The systematic neurological questionnaire has not been shown to be useful in this context. These result highlight the need to educate patients about possible subacute signs that should lead to contact the treating physicians and the need for a close cooperation between dermatologists/oncologists and neurologists.