Table 1. Clinical Features and Outcomes After Treatment.
Patient No./Sexa | Cancer Diagnosis | Treatment | Cycles to Onset of Neurological Complication | Neurological Diagnosis | Modified Rankin Scale Score | Treatment Stopped | Additional Treatments | Neurological Outcome | Modified Rankin Scale Score After Treatment |
---|---|---|---|---|---|---|---|---|---|
1/Male | Stage IV melanoma | Pembrolizumab | 2 | Severe necrotizing myopathy | 5 | Yes | Prednisone (80 mg daily) for 12 d, 3 sessions of plasmapheresis | Death | 6 |
2/Male | Stage IV melanoma | Pembrolizumab | 1 | Myopathy | 1 | Yes | Methylprednisolone (1-g single dose), prednisone (100 mg daily) for 3 d and then prednisone (60 mg daily), tapering weekly over 1 mo | Improved | 0 |
3/Male | Stage IV melanoma | Pembrolizumab | 10 | Axonal thoracolumbar polyradiculopathy | 4 | Yes | Prednisone (30 mg daily), weekly taper over 1 mo, IVIG (1 g/kg) for 2 doses | Improved | 2 |
4/Male | Stage IV melanoma | Pembrolizumab | 6 | Severe demyelinating length-dependent peripheral neuropathy with axonal loss | 3 | Yes | Prednisone (120 mg daily), followed by slow taper over 2.5 mo | Improved | 2 |
5/Male | Stage IV melanoma | Pembrolizumab | 20 | Facial diplegic variant of Guillain-Barré syndrome | 2 | Yes | IVIG (0.4 g/kg daily) for 5 d | Improved | 1 |
6/Male | Stage IV peritoneal mesothelioma | Nivolumab | 5 | Asymmetric vasculitic neuropathy | 3 | Yes | Methylprednisolone (1 g intravenously daily) for 5 d, prednisone (60 mg daily), tapering over 3 wk | Improved | 3 |
7/Male | Stage IV lung adenocarcinoma | Pembrolizumab | 11 | Cerebellar ataxia and dysarthria | 4 | Yes | None | Improved | 2 |
8/Male | Stage IV esophageal adenocarcinoma | Pembrolizumab | 3 | Autoimmune retinopathy | 2 | No | IVIG (0.4 g/kg) 3 consecutive days every 3 wk | Improved | 2 |
9/Female | Stage IV leiomyosarcoma | Nivolumab | 3 | Bilateral internuclear ophthalmoplegia | 2 | No | Corticosteroid (dose unknown) for 1 wk | Improved | 0 |
10/Female | Stage IV lung adenocarcinoma | Nivolumab | 14 | Headache | 2 | No | Dexamethasone (4 mg twice daily) for 1 wk | Improved | 0 |
Abbreviation: IVIG, intravenous immunoglobulin.
Ages range from 31-78 years.