Clinical characteristics of immunorelated encephalitis caused by programmed death receptor-1 inhibitors:A report of 7 cases
Objective Summarize the clinical characteristics and diagnosis of patients with solid tumors presenting with immune-related encephalitis treated associated with programmed death receptor-1 inhibitors to improve clinicians'understanding of the disease.Methods The clinical characteristics,diagnostic and treatment history,and survival of patients with solid tumors of immune encephalitis associated with PD-1 inhibitor therapy at Peking University International Hospital was retrospectively analyzed.Results Seven patients were included in the study,five males and two females,with a median age of 62 years(50-67 years),and the number of PD-1 inhibitor treatments applied in first-,second-,and third-line cases was four,one,and two,respectively.All patients were mentally normal and did not have active central system metastases before treatment with PD-1 inhibitors.The median number of cycles of PD-1 inhibitor treatment before the onset of neurological symptoms was 2(2-7),with altered mental status,memory loss and disorientation being the most common symptoms.Five patients had no abnormalities on MRI or CT of the brain.The level of neutrophil-lymphocyte ratio(NRL)at the onset of symptoms was elevated in all six patients compared to baseline.Six patients were treated with corticosteroids,with a median time to remission of 3 days(16 hours-5 days).Four patients experienced rapid symptomatic relief with corticosteroids without sequelae.Two patients were subsequently rechallenged with a PD-1 inhibitor therapy.Conclusion Immune-associated encephalitis is a rare but serious complication of PD-1 inhibitor therapy that may have a favorable prognosis if it is recognized early and treated with corticosteroids as early as possible.
Programmed-death protein 1(PD-1)Immune-related encephalitisCorticosteroid
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