TABLE 3.
Management of suspected neurological immune-related adverse effects (irAEs)
| Grade/CTCAE | Management | |
|---|---|---|
| Grade 1 | Mild symptoms | Consider to withhold ICI |
| No interference with function | Close monitoring for any progression | |
| Symptoms not concerning to patient | If irAEs worsen or do not improve, consider permanent discontinuation | |
| Grade 2 | Moderate symptoms | Withhold ICI |
| Cranial nerve involvement. Some interference with ADL. Symptoms concerning to patient | If irAEs worsen or do not improve (going to grade 1), consider permanent discontinuation | |
| Start 0.5–1.0 mg kg−1 day−1 prednisolone equivalents PO or IV; if worsening symptoms, 1–2 mg kg−1 day−1 | ||
| *Initial observation reasonable | ||
| Grade 3 | Severe symptoms | Permanently discontinue ICI |
| Limits self-care | Start 1–2 mg kg−1 day−1 prednisolone equivalents PO or IV | |
| Grade 4 | Life-threatening consequences | Permanently discontinue ICI |
| Start 2 mg/kg−1/day−1 prednisolone equivalents PO or IV | ||
CTCAE: Common Terminology Criteria for Adverse Events. ADL: activities of daily living. PO: per oral. IV: intravenous.