AI Article Synopsis
- A 43-year-old woman with advanced pancreatic cancer was treated with a combination of toripalimab, chemotherapy, and experienced immune-related encephalopathy, marked by stuttering.* -
- Magnetic resonance imaging revealed multiple cerebral white matter changes, alongside elevated cardiac enzymes and hypothyroidism, which are potential immune-related adverse events.* -
- The case highlights the importance of recognizing early signs of neurotoxicity, like stuttering, in patients receiving immune checkpoint inhibitors to improve management of rare neurological side effects.*
Article Abstract
Background: Immune checkpoint inhibitor (ICI) combined with chemotherapy has exhibited promising results in small sample studies of pancreatic cancer patients. The efficacy of toripalimab, a programmed cell death protein 1 (PD-1) monoclonal antibody has been explored in the previous studies and it was established that immune-related adverse events (irAEs) associated with administration of this drug deserve proper attention and adequate management.
Case Presentation: A 43-year-old female patient with advanced pancreatic ductal adenocarcinoma (PDAC) was treated with toripalimab in combination with gemcitabine and nab-paclitaxel (T-GA) as the first-line treatment. She developed immune-related encephalopathy with stuttering as the main clinical symptom and Magnetic resonance imaging (MRI) showed multiple cerebral white matter demyelination changes, concomitant with asymptomatic cardiac enzyme elevation and hypothyroidism. The symptoms resolved after the discontinuation of toripalimab and corticosteroid treatment.
Conclusions: Stuttering might be an early sign of neurotoxicity which can be easily neglected during the treatment. These findings provide guidance for the identification of these rare and occult neurological irAEs (n-irAEs) in the clinical practice.
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| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9985276 | PMC |
| http://dx.doi.org/10.1186/s12883-023-03140-7 | DOI Listing |
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