Skip to main content
Erschienen in: Strahlentherapie und Onkologie 7/2020

31.01.2020 | Case Study

An autoimmune-based, paraneoplastic neurologic syndrome following checkpoint inhibition and concurrent radiotherapy for merkel cell carcinoma: case report

verfasst von: Alexander D. Sherry, Michael Bezzerides, Mohamed H. Khattab, Guozhen Luo, Kristin K. Ancell, Austin N. Kirschner, MD, PhD

Erschienen in: Strahlentherapie und Onkologie | Ausgabe 7/2020

Einloggen, um Zugang zu erhalten

Abstract

Purpose

Merkel cell carcinoma is highly sensitive to both radiation and immunotherapy. Moreover, concurrent radioimmunotherapy may capitalize on anti-tumor immune activity and improve Merkel cell treatment response, although an enhanced immune system may cross-react with native tissues and lead to significant sequelae.

Methods

Here we present a case study of a patient with metastatic Merkel cell carcinoma treated with radiotherapy concurrent with pembrolizumab.

Results

After radioimmunotherapy, the patient developed sensory neuropathy, visual hallucinations, and mixed motor neuron findings. Neurologic dysfunction progressed to profound gastrointestinal dysmotility necessitating parenteral nutrition and intubation with eventual expiration.

Conclusion

This case represents a unique autoimmune paraneoplastic neurologic syndrome, likely specific to neuroendocrine tumors and motivated by concurrent radioimmunotherapy. Recognition of the potential role of radioimmunotherapy may provide an advantage in anticipating these severe sequelae.
Anhänge
Nur mit Berechtigung zugänglich
Fußnoten
1
Timmerman R (2014) Personal communication
 
Literatur
21.
Zurück zum Zitat Santomasso B, D’Angelo S (2018) Anti-CRMP5-associated paraneoplastic neurologic syndrome developing in a patient with metastatic Merkel cell carcinoma during immune checkpoint inhibitor treatment. Neurology 90:P5.409 Santomasso B, D’Angelo S (2018) Anti-CRMP5-associated paraneoplastic neurologic syndrome developing in a patient with metastatic Merkel cell carcinoma during immune checkpoint inhibitor treatment. Neurology 90:P5.409
30.
Zurück zum Zitat NCCN (2018) NCCN clinical practice guidelines in oncology (NCCN guidelines): gastric cancer version 2.2018 NCCN (2018) NCCN clinical practice guidelines in oncology (NCCN guidelines): gastric cancer version 2.2018
32.
Zurück zum Zitat Banerjee R, Chakraborty S, Nygren I, Sinha R (2013) Small bowel dose parameters predicting grade ≥3 acute toxicity in rectal cancer patients treated with neoadjuvant chemoradiation: an independent validation study comparing peritoneal space versus small bowel loop contouring techniques. Int J Radiat Oncol Biol Phys 85:1225–1231. https://doi.org/10.1016/j.ijrobp.2012.09.036 CrossRefPubMed Banerjee R, Chakraborty S, Nygren I, Sinha R (2013) Small bowel dose parameters predicting grade ≥3 acute toxicity in rectal cancer patients treated with neoadjuvant chemoradiation: an independent validation study comparing peritoneal space versus small bowel loop contouring techniques. Int J Radiat Oncol Biol Phys 85:1225–1231. https://​doi.​org/​10.​1016/​j.​ijrobp.​2012.​09.​036 CrossRefPubMed
38.
Metadaten
Titel
An autoimmune-based, paraneoplastic neurologic syndrome following checkpoint inhibition and concurrent radiotherapy for merkel cell carcinoma: case report
verfasst von
Alexander D. Sherry
Michael Bezzerides
Mohamed H. Khattab
Guozhen Luo
Kristin K. Ancell
Austin N. Kirschner, MD, PhD
Publikationsdatum
31.01.2020
Verlag
Springer Berlin Heidelberg
Erschienen in
Strahlentherapie und Onkologie / Ausgabe 7/2020
Print ISSN: 0179-7158
Elektronische ISSN: 1439-099X
DOI
https://doi.org/10.1007/s00066-020-01582-3

Weitere Artikel der Ausgabe 7/2020

Strahlentherapie und Onkologie 7/2020 Zur Ausgabe

Update Onkologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.