Shiravand Y, Khodadadi F, Kashani SMA, Hosseini-Fard SR, Hosseini S, Sadeghirad H, et al. Immune checkpoint inhibitors in cancer therapy. Curr Oncol. 2022;29(5):3044–60. https://doi.org/10.3390/curroncol29050247.

Article  PubMed  PubMed Central  Google Scholar 

• Haugh AM, Probasco JC, Johnson DB. Neurologic complications of immune checkpoint inhibitors. Expert Opin Drug Saf. 2020;19(4):479–88. https://doi.org/10.1080/14740338.2020.1738382. The authors provide a comprehensive review of the different neurological complications of ICIs.

Article  CAS  PubMed  PubMed Central  Google Scholar 

Twomey JD, Zhang B. Cancer immunotherapy update: FDA-approved checkpoint inhibitors and companion diagnostics. Aaps j. 2021;23(2):39. https://doi.org/10.1208/s12248-021-00574-0.

Article  PubMed  Google Scholar 

Vaddepally R, Doddamani R, Sodavarapu S, Madam NR, Katkar R, Kutadi AP, et al. Review of immune-related adverse events (irAEs) in non-small-cell lung cancer (NSCLC)-their incidence, management, multiorgan irAEs, and rechallenge. Biomedicines. 2022;10(4). https://doi.org/10.3390/biomedicines10040790.

Danlos FX, Voisin AL, Dyevre V, Michot JM, Routier E, Taillade L, et al. Safety and efficacy of anti-programmed death 1 antibodies in patients with cancer and pre-existing autoimmune or inflammatory disease. Eur J Cancer. 2018;91:21–9. https://doi.org/10.1016/j.ejca.2017.12.008.

Article  CAS  PubMed  Google Scholar 

• Yshii LM, Hohlfeld R, Liblau RS. Inflammatory CNS disease caused by immune checkpoint inhibitors: status and perspectives. Nat Rev Neurol. 2017;13(12):755–63. https://doi.org/10.1038/nrneurol.2017.144. This paper surveys various theories about the pathophysiology and mechanism of CNS disease with ICIs.

Article  CAS  PubMed  Google Scholar 

Puzanov I, Diab A, Abdallah K, Bingham CO 3rd, Brogdon C, Dadu R, et al. Managing toxicities associated with immune checkpoint inhibitors: consensus recommendations from the Society for Immunotherapy of Cancer (SITC) Toxicity Management Working Group. J Immunother Cancer. 2017;5(1):95. https://doi.org/10.1186/s40425-017-0300-z.

Article  CAS  PubMed  PubMed Central  Google Scholar 

Abdel-Wahab N, Shah M, Lopez-Olivo MA, Suarez-Almazor ME. Use of immune checkpoint inhibitors in the treatment of patients with cancer and pre-existing autoimmune disease: a systematic review. Ann Intern Med. 2018;168(2):121–30. https://doi.org/10.7326/m17-2073.

Article  PubMed  Google Scholar 

Calvo V, Fernández MA, Collazo-Lorduy A, Franco F, Núñez B, Provencio M. Use of immune checkpoint inhibitors in patients with solid tumors and pre-existing autoimmune or inflammatory disease: real-world data. Lung Cancer Manag. 2021;10(4):Lmt51. https://doi.org/10.2217/lmt-2021-0003.

Article  CAS  PubMed  PubMed Central  Google Scholar 

•• Haanen J, Ernstoff MS, Wang Y, Menzies AM, Puzanov I, Grivas P, et al. Autoimmune diseases and immune-checkpoint inhibitors for cancer therapy: review of the literature and personalized risk-based prevention strategy. Ann Oncol. 2020;31(6):724–44. https://doi.org/10.1016/j.annonc.2020.03.285.T. The authors propose risk-mitigation strategies for patients with pre-existing AID who plan to start ICI therapy

Article  CAS  PubMed  Google Scholar 

Jordan B, Benesova K, Hassel JC, Wick W, Jordan K. How we identify and treat neuromuscular toxicity induced by immune checkpoint inhibitors. ESMO Open. 2021;6(6):100317. https://doi.org/10.1016/j.esmoop.2021.100317.

Article  CAS  PubMed  PubMed Central  Google Scholar 

Abidoye O, Kim N, Fombi J. An interesting case report of myasthenia gravis exacerbation induced by durvalumab. Cureus. 2022;14(7):e26985. https://doi.org/10.7759/cureus.26985.

Article  PubMed  PubMed Central  Google Scholar 

Cooper DS, Meriggioli MN, Bonomi PD, Malik R. Severe exacerbation of myasthenia gravis associated with checkpoint inhibitor immunotherapy. J Neuromuscul Dis. 2017;4(2):169–73. https://doi.org/10.3233/jnd-170219.

Article  PubMed  Google Scholar 

Earl DE, Loochtan AI, Bedlack RS. Refractory myasthenia gravis exacerbation triggered by pembrolizumab. Muscle Nerve. 2018;57(4):E120-e121.

Article  PubMed  Google Scholar 

Zhu J, Li Y. Myasthenia gravis exacerbation associated with pembrolizumab. Muscle Nerve. 2016;54(3):506–7. https://doi.org/10.1002/mus.25055.

Article  PubMed  Google Scholar 

Kamien AK, Ana; Santhosh-Kumar, Cheruppolil. Reactivation of myasthenia gravis secondary to nivolumab: case report and literature review. J Hematol Oncol Pharm. 2019;9(1):24–9.

Lau KH, et al. Exacerbation of myasthenia gravis in a patient with melanoma treated with pembrolizumab. Muscle Nerve. 2016;54(1):157–61.

Article  PubMed  Google Scholar 

Maeda O, Yokota K, Atsuta N, Katsuno M, Akiyama M, Ando Y. Nivolumab for the treatment of malignant melanoma in a patient with pre-existing myasthenia gravis. Nagoya J Med Sci. 2016;78(1):119–22.

PubMed  PubMed Central  Google Scholar 

• Snavely A, Pérez-Torres EJ, Weber JS, Sandigursky S, Thawani SP. Immune checkpoint inhibition in patients with inactive pre-existing neuromuscular autoimmune diseases. J Neurol Sci. 2022;438:120275. https://doi.org/10.1016/j.jns.2022.120275. This case series documents neurologic outcomes in patients with pre-existing neuromuscular autoimmune diseases who are treated with ICI

Article  CAS  PubMed  Google Scholar 

Mitsune A, Yanagisawa S, Fukuhara T, Miyauchi E, Morita M, Ono M, et al. Relapsed myasthenia gravis after nivolumab treatment. Intern Med. 2018;57(13):1893–7. https://doi.org/10.2169/internalmedicine.9153-17.

Article  PubMed  PubMed Central  Google Scholar 

Phadke SD, Ghabour R, Swick BL, Swenson A, Milhem M, Zakharia Y. Pembrolizumab therapy triggering an exacerbation of pre-existing autoimmune disease: a report of 2 patient cases. J Investig Med High Impact Case Rep. 2016;4(4):2324709616674316. https://doi.org/10.1177/2324709616674316.

Article  PubMed  PubMed Central  Google Scholar 

Safa H, Johnson DH, Trinh VA, Rodgers TE, Lin H, Suarez-Almazor ME, et al. Immune checkpoint inhibitor-related myasthenia gravis: single center experience and systematic review of the literature. J Immunother Cancer. 2019;7(1):319. https://doi.org/10.1186/s40425-019-0774-y.

Article  PubMed  PubMed Central  Google Scholar 

Williams S, et al. Outcome of patient with myasthenia gravis with the use of immunotherapy in metastatic Merkel cell carcinoma. Oxf Med Case Reports. 2022;2022(2):omac012.

Article  PubMed  PubMed Central  Google Scholar 

Zaremba A, et al. Metastatic Merkel cell carcinoma and myasthenia gravis: contraindication for therapy with immune checkpoint inhibitors? J Immunother Cancer. 2019;7(1):141. https://doi.org/10.1186/s40425-019-0626-9 

Menzies AM, Johnson DB, Ramanujam S, Atkinson VG, Wong ANM, Park JJ, et al. Anti-PD-1 therapy in patients with advanced melanoma and pre-existing autoimmune disorders or major toxicity with ipilimumab. Ann Oncol. 2017;28(2):368–76. https://doi.org/10.1093/annonc/mdw443.

Article  CAS  PubMed  Google Scholar 

Johnson DB, Sullivan RJ, Ott PA, Carlino MS, Khushalani NI, Ye F, et al. Ipilimumab therapy in patients with advanced melanoma and pre-existing autoimmune disorders. JAMA Oncol. 2016;2(2):234–40. https://doi.org/10.1001/jamaoncol.2015.4368.

Article  PubMed  Google Scholar 

Ishii A, Yokoyama M, Tsuji H, Fujii Y, Tamaoka A. Pembrolizumab treatment of metastatic urothelial cancer without exacerbating myasthenia gravis. eNeurologicalSci. 2020;19:100236. https://doi.org/10.1016/j.ensci.2020.100236.

Article  PubMed  PubMed Central  Google Scholar 

Sanders DB, Burns TM, Cutter GR, Massey JM, Juel VC, Hobson-Webb L. Does change in acetylcholine receptor antibody level correlate with clinical change in myasthenia gravis? Muscle Nerve. 2014;49(4):483–6. https://doi.org/10.1002/mus.23944.

Article  CAS  PubMed  Google Scholar 

•• Khan E, Shrestha AK, Elkhooly M, Wilson H, Ebbert M, Srivastava S, et al. CNS and PNS manifestation in immune checkpoint inhibitors: a systematic review. J Neurol Sci. 2022;432:120089. https://doi.org/10.1016/j.jns.2021.120089. A well-written, comprehensive review of nirAEs of ICIs.

Article  CAS  PubMed  Google Scholar 

Thomas R, Patel H, Scott J. Dermatomyositis flare with immune checkpoint inhibitor therapy for melanoma. Cureus. 2021;13(4):e14387. https://doi.org/10.7759/cureus.14387.

Article  PubMed  PubMed Central  Google Scholar 

Manson G, Maria ATJ, Poizeau F, Danlos FX, Kostine M, Brosseau S, et al. Worsening and newly diagnosed paraneoplastic syndromes following anti-PD-1 or anti-PD-L1 immunotherapies, a descriptive study. J Immunother Cancer. 2019;7(1):337. https://doi.org/10.1186/s40425-019-0821-8.

Article  PubMed  PubMed Central  Google Scholar 

Uchio N, Unuma A, Kakumoto T, Osaki M, Zenke Y, Sakuta K, et al. Pembrolizumab on pre-existing inclusion body myositis: a case report. BMC Rheumatol. 2020;4:48. https://doi.org/10.1186/s41927-020-00144-5.

Article  PubMed  PubMed Central  Google Scholar 

Puwanant A, Isfort M, Lacomis D, Živković SA. Clinical spectrum of neuromuscular complications after immune checkpoint inhibition. Neuromuscul Disord. 2019;29(2):127–33. https://doi.org/10.1016/j.nmd.2018.11.012.

Article  PubMed  Google Scholar 

Wang C, Sandhu J, Fakih M. Complete response to pembrolizumab in a patient with metastatic colon cancer with microsatellite instability and a history of Guillain-Barre syndrome. J Gastrointest Oncol. 2019;10(1):161–5. https://doi.org/10.21037/jgo.2018.09.19.

Article  PubMed  PubMed Central  Google Scholar 

Cortellini A, Parisi A, Fargnoli MC, Cannita K, Irelli A, Porzio G, et al. Safe administration of ipilimumab, pembrolizumab, and nivolumab in a patient with metastatic melanoma, psoriasis, and a previous Guillain-Barré syndrome. Case Rep Oncol Med. 2018;2018:2783917. https://doi.org/10.1155/2018/2783917.

Article  PubMed  PubMed Central  Google Scholar