Atezolizumab-induced encephalitis in a patient with metastatic breast cancer: a case report and review of neurological adverse events associated with checkpoint inhibitors
1 U.S. Food & Drug Administration – FDA. FDA approves first treatment for rare form of skin cancer. Spring, MD: FDA; 2017 [cited 2019 Oct 10]. Available from:
2 Schmid P, Adams S, Rugo HS, et al. Atezolizumab and nab-paclitaxel in advanced triple-negative breast cancer. N Engl J Med. 2018;379(22):2108-21.
3 Pardoll DM. The blockade of immune checkpoints in cancer immunotherapy. Nat Rev Cancer. 2012;12(4):252-64.
4 Trinh S, Le A, Gowani S, La-Beck NM. Management of immune-related adverse events associated with immune checkpoint inhibitor therapy: a minireview of current clinical guidelines. Asia Pac J Oncol Nurs. 2019;6(2):154-60.
5 Larkin J, Chmielowski B, Lao CD, et al. Neurologic serious adverse events associated with nivolumab plus ipilimumab or nivolumab alone in advanced melanoma, including a case series of encephalitis. Oncologist. 2017;22(6):709-18.
6 Laserna A, Tummala S, Patel N, El Hamouda DEM, Gutiérrez C. Atezolizumab-related encephalitis in the intensive care unit: case report and review of the literature. SAGE Open Med Case Rep. 2018;6:6.
7 Arakawa M, Yamazaki M, Toda Y, et al. Atezolizumab-induced encephalitis in metastatic lung cancer: a case report and literature review. eNeurologicalSci. 2018;14:49-50.
8 Levine JJ, Somer RA, Hosoya H, Squillante C. Atezolizumab-induced Encephalitis in Metastatic Bladder Cancer: A Case Report and Review of the Literature. Clin Genitourin Cancer. 2017;15(5):e847-9.
9 Kim A, Keam B, Cheun H, Lee S-T, Gook HS, Han M-K. Immune-Checkpoint-Inhibitor-Induced Severe Autoimmune Encephalitis Treated by Steroid and Intravenous Immunoglobulin. J Clin Neurol. 2019;15(2):259-61.
10 Dalakas MC. Neurological complications of immune checkpoint inhibitors: what happens when you ‘take the brakes off’ the immune system. Ther Adv Neurol Disorder. 2018;11:175628641879986.
11 Spain L, Tippu Z, Larkin JM, Carr A, Turajlic S. How we treat neurological toxicity from immune checkpoint inhibitors. ESMO Open. 2019;4(Suppl 4):e000540.
12 Makarious D, Horwood K, Coward J. Myasthenia gravis: an emerging toxicity of immune checkpoint inhibitors. Eur J Cancer. 2017;82:128-36.
13 Feng S, Coward J, Mccaffrey E, Coucher J, Kalokerinos P, O’Byrne K. Pembrolizumab-induced encephalopathy: a review of neurological toxicities with immune checkpoint inhibitors. J Thorac Oncol. 2017;12(11):1626-35.
14 Becquart O, Lacotte J, Malissart P, et al. Myasthenia gravis induced by immune checkpoint inhibitors. J Immunother. 2019;42(8):309-12.
15 National Comprehensive Cancer Network. Management of immunotherapy related toxicities (Version 2). 2019 [cited 2019 Oct 10]. Available from:
16 Hottinger AF. Neurologic complications of immune checkpoint inhibitors. Curr Opin Neurol. 2016;29(6):806-12.
17 Supakornnumporn S, Katirji B. Guillain–Barré Syndrome Triggered by Immune Checkpoint Inhibitors. J Clin Neuromuscul Dis. 2017;19(2):80-3.
18 Kyriazoglou A, Liontos M, Papadopoulos C, et al. Guillain-Barré Syndrome related to nivolumab: case report of a patient with urothelial cancer and review of the literature. Clin Genitourin Cancer. 2019;17(2):e360-4.
19 Patel AS, Snook RJ, Sehdev A. Chronic inflammatory demyelinating polyradiculoneuropathy secondary to immune checkpoint inhibitors in melanoma patients. Discov Med. 2019;28(152):107-11. PMid:31926582.
20 Astaras C, de Micheli R, Moura B, Hundsberger T, Hottinger AF. Neurological adverse events associated with immune checkpoint inhibitors: diagnosis and management. Curr Neurol Neurosci Rep. 2018;18(1):3.
21 Spain L, Walls G, Julve M, et al. Neurotoxicity from immune-checkpoint inhibition in the treatment of melanoma: a single centre experience and review of the literature. Ann Oncol. 2017;28(2):377-85.
22 Conry R. Central nervous system toxicities of anti-cancer immune checkpoint blockade. Journal of Neurology and Neuromedicine. 2016;1(4):39-45.