par Duvigneaud, Zachary 
;Wolff, Louis ;Ilzkovitz, M.;Meert, Anne-Pascale ;Ferlini, Lorenzo
Référence Revue médicale de Bruxelles, 47, Special Issue, page (78-85)
Publication Publié, 2026-10-01
;Wolff, Louis ;Ilzkovitz, M.;Meert, Anne-Pascale ;Ferlini, Lorenzo Référence Revue médicale de Bruxelles, 47, Special Issue, page (78-85)
Publication Publié, 2026-10-01
Article révisé par les pairs
| Résumé : | Immune checkpoint inhibitors (ICI) have transformed cancer therapy, but their use can lead to peripheral neurological immune-related adverse events (irAEs) that may result in disabling sequelae. A comprehensive review of the literature was conducted to characterize the clinical manifestations, proposed pathophysiological mechanisms, diagnostic strategies, and therapeutic approaches for ICI-induced peripheral neurological toxicities. Peripheral neurological complications include myopathy and neuropathy, which typically occur within weeks of ICI initiation. Diagnosis relies on clinical evaluation, electromyography, cerebrospinal fluid analysis, and the detection of specific autoantibodies. First-line treatment is based on corticosteroids, with the addition of intravenous immunoglobulins (IVIG) or plasmapheresis in severe cases. Therapeutic escalation may be necessary in resistant forms. The safety of ICI rechallenge after a neurological irAE remains controversial and should be guided by the type and severity of the initial toxicity. Early recognition and prompt management of ICI-induced peripheral neurological toxicities are crucial to minimize patient morbidity. A structured diagnostic approach and multidisciplinary collaboration are essential. Further studies are needed to guide safe and effective rechallenge strategies. |
