Severe meningo-radiculo-nevritis associated with ipilimumab

Summary Purpose Ipilimumab is a T-cell-potentiating monoclonal antibody directed against cytotoxic T-lymphocyte antigen-4 (CTLA-4) to promote antitumoural immunity. In phase III trials, ipilimumab was shown to be the first agent to improve survival in advanced melanoma patients, regardless of previo...

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Bibliographic Details
Published in:Investigational new drugs 2012-12, Vol.30 (6), p.2407-2410
Main Authors: Bompaire, Flavie, Mateus, Christine, Taillia, Hervé, De Greslan, Thierry, Lahutte, Marion, Sallansonnet-Froment, Magali, Ouologuem, Madani, Renard, Jean-Luc, Gorochov, Guy, Robert, Caroline, Ricard, Damien
Format: Article
Language:English
Subjects:
Antigens
Cancer therapies
Case reports
Cerebrospinal fluid
Clinical trials
CTLA-4 protein
Cytotoxicity
Disease
Drug dosages
Hepatitis
Inflammatory bowel disease
Laboratories
Lymphatic system
Lymphocytes
Lymphocytes T
Medical treatment
Medicine
Medicine & Public Health
Melanoma
Meningitis
Metastasis
Monoclonal antibodies
Neurological diseases
Oncology
Patients
Pharmacology
Pharmacology/Toxicology
Short Report
Side effects
Signs and symptoms
Steroid hormones
Steroids
Studies
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Summary:Summary Purpose Ipilimumab is a T-cell-potentiating monoclonal antibody directed against cytotoxic T-lymphocyte antigen-4 (CTLA-4) to promote antitumoural immunity. In phase III trials, ipilimumab was shown to be the first agent to improve survival in advanced melanoma patients, regardless of previous treatment. We report a case of severe neurologic disease after ipilimumab treatment. Patient and methods Neurologic symptoms including facial diplegia, tetraplegia, areflexia progressed with time a few days after the fourth monthly ipilimumab infusion. Analysis of the cerebro-spinal fluid showed elevated proteinorachy and lymphocytic meningitis. Despite high doses of steroids and symptomatic treatment, the symptoms worsened. Results Veinoglobulins were then infused and the patient began to improve and recovered almost normal activity two years later. Conclusion The adverse event profile associated with ipilimumab was primarily immune-related. This is the first case in which such a severe event has been reported.
ISSN:0167-6997
1573-0646
DOI:10.1007/s10637-011-9787-1