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- W2966266548 abstract "Objective: To describe the clinical spectrum, management and clinical outcomes of neurologic immune-related adverse events (IrAEs) in a large cohort of patients who received immune checkpoint inhibitors (ICIs). Background: Expanding use of ICIs underscores the importance of accurate diagnosis and prompt management of neurologic IrAEs. Because neurologic irAEs may present atypically with overlap, and optimal management is unknown, comprehensive phenotypic characterization and long-term outcome data are needed. Design/Methods: Patients who received an ICI at Massachusetts General Hospital between 06/01/2011 and 12/31/2017 were identified. The instituitional-database-registry was utilized to search for relevant diagnostic-codes and/or diagnostic evaluations. We reviewed medical records of the screened cases for clinical data. Change in modified Rankin score ≥1 was considered as a favorable outcome. Results: From 2011 to 2017, 1851 patients received ICIs at our institution. Twenty-eight (1.5%) patients had grade 3 (limit self-care activities of daily living) or 4 (life threatening and need urgent intervention) neurological IrAEs. Underlying malignancies included melanoma (n=21), adenocarcinoma (n=5), renal cell carcinoma (n=1) and Hodgkin’s lymphoma (n=1). The rate of neurological IrAEs was significantly higher with use of cytotoxic-T-lymphocyte-antigen-4 inhibitors (anti-CTLA4) alone (2.8%) or in combination with programmed-death-1 inhibitors (anti-PD1) (2.7%) compared to anti-PD1 monotherapy (0.8%, p Conclusions: Neurological irAEs are rare but potentially severe complications of ICIs. Recognition of their wide and overlapping phenotypic spectrum, distinct clinical characteristics and prompt management with corticosteroids may lead to favorable outcomes. Disclosure: Dr. Dubey has nothing to disclose. Dr. David has received royalty from Oakstone Publishing. Dr. Reynolds has nothing to disclose. Dr. Chute has nothing to disclose. Dr. Clement has nothing to disclose. Dr. Cohen has nothing to disclose. Dr. Lawrence has nothing to disclose. Dr. Mooradian has nothing to disclose. Dr. Sullivan has received personal compensation for consulting, serving on a scientific advisory board, speaking, or other activities with Merck, Genentech, and Novartis. Dr. Guidon has received personal compensation for consulting, serving on a scientific advisory board, speaking, or other activities with Momenta Pharmaceutics, Alexion and Oakstone Publishing. Dr. Guidon has received research support from RaPharma." @default.
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- W2966266548 date "2019-04-09" @default.
- W2966266548 modified "2023-09-23" @default.
- W2966266548 title "Immune checkpoint inhibitor related neurologic adverse events: clinical spectrum, management and outcomes (S21.003)" @default.
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