Neurologic Complications of Immune Checkpoint Inhibitors in Thoracic Malignancies

Immune checkpoint inhibitors (ICIs) have transformed the prognosis of cancers previously considered lethal. The spectrum therapeutic indications is rapidly expanding, including vast majority thoracic malignancies. By enhancing immune responses against cancer, ICI treatments lead to development immune-related adverse events (irAEs) that may affect any organ. Severity varies from mild fatal clinical manifestations. Neurologic involvement relatively rare and highly heterogeneous, central peripheral nervous system diseases associated with neural-specific autoantibodies or not, vasculitis, granulomatous demyelinating disorders. Symptoms often manifest within first four cycles treatment can develop regardless class used. An unfavorable outcome found in up one-third patients generally patients’ characteristics (e.g., age, coexistence systemic events), cancer type lung versus other), specific setting preexisting paraneoplastic neurologic autoimmunity, rechallenge after a irAE). Diagnosis should be suspected new-onset symptoms while on which are not explained by metastatic disease other metabolic/infectious Recommended based severity consists discontinuation without immunosuppressive/immunomodulatory therapy, although alternative approaches reasonable depending status aggressive immunosuppression discontinuing initial response). Early recognition appropriate these irAEs crucial for improved patient outcomes planning.