Checkpoint Inhibitor-Induced Central Nervous System Autoimmunity: A Case Series (P3.418)

Objective: N/A Background: Clinical trials of immune checkpoint inhibitors have demonstrated significant survival benefits in a variety of advanced malignancies. However, they have also been associated with a number of immune-related adverse effects. Design/Methods: We present three cases of previously unreported central nervous system autoimmunity following checkpoint inhibitor therapy. Our patients had CNS manifestations ranging from bilateral ballismus with new MRI changes, neurosarcoidosis, and GAD antibody associated cerebellar degeneration. Results: All of the above cases seem unlikely to be purely paraneoplastic given the temporal association with the cancer immunotherapy. Treatment approaches to central nervous system immune-related adverse events widely vary and the prognosis is variable. Conclusions: Further studies into checkpoint inhibitor-induced neurologic immune disease are warranted. Early detection is crucial to adequately address the manifestations of immune therapy related neurologic adverse effects. Study Supported by: N/A Disclosure: Dr. Shah has nothing to disclose. Dr. Dunn-Pirio has nothing to disclose. Dr. Luedke has nothing to disclose. Dr. Morgenlander has nothing to disclose. Dr. Skeen has received personal compensation for consulting, serving on a scientific advisory board, speaking, or other activities with Biogen, Novartis, Celgene, Mallinckrodt, genentech and genzyme. Dr. Skeen has received research support from Novartis and Abbvi. Dr. Eckstein has nothing to disclose.