Autoimmune paraneoplastic syndromes associated to lung cancer: A systematic review of the literature Part 4: Neurological paraneoplastic syndromes, involving the peripheral nervous system and the neuromuscular junction and muscles

Ruelle, Lucien; Bentea, Georgiana Pintea; Sideris, Spyridon; Koulali, Mohamed El; Holbrechts, Stéphane; Lafitte, Jean-Jacques; Grigoriu, Bogdan; Sculier, Claudine; Meert, Anne-Pascale; Durieux, Valérie; Berghmans, Thierry; Sculier, Jean-Paul

doi:10.1016/j.lungcan.2017.07.025

Cited by 7 publications

(17 citation statements)

References 219 publications

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“…The most frequent manifestations found were rheumatoid arthritis (5.9%), psoriasis (2.8%), polymyalgia rheumatica (1.8%), Addison disease (1%), systemic lupus erythematosus (SLE-−0.9%), ulcerative colitis (0.8%), giant cell arteritis (0.8%), sicca syndrome (0.6%), regional enteritis (0.5%), and Meniere disease (0.5%). However, these autoimmune manifestations can be very broad as it has been recently reviewed for lung cancer in a series of articles curated by Jean Paul Scuiler (1,(8)(9)(10)(11).…”

Section: Introductionmentioning

confidence: 99%

Efficacy and Toxicity of Immune -Checkpoint Inhibitors in Patients With Preexisting Autoimmune Disorders

et al. 2020

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Immunotherapy is an important armamentarium for cancer treatment nowadays. Apart from their significant effectiveness in controlling disease they also generate potential severe immune related adverse effects. Preexistence of immune related conditions may eventually predispose to the development of more severe complication and extreme caution have been taken in treating these patients. We performed a literature review searching for case reports and case series in order to offer evidence-based data for clinical management of these patients. Preexisting serological-only immune abnormalities or presence of a predisposing genetic background does not seem to confer significant risk but existing data is scarce. Most patients with preexistent autoimmune diseases can probably treated with checkpoint inhibitors as they seem to have at least the same response rate as the general cancer population. Under treatment, a significant part of them (at least 30%) can experience a flare of their baseline disease which can sometime be severe. Life-threatening cases seems rare and disease flare can be generally managed with steroids. The volume of available data is more important for rheumatologic diseases than for inflammatory bowel diseases were more caution should be observed. However, it has to be kept in mind that new immune related adverse effects (IrAE) are seen with a similar frequency as the flare of the baseline disease. Both flare-up's and newly developed IrAE are generally manageable with a careful clinical follow-up and prompt therapy.

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Section: Introductionmentioning

confidence: 99%

Efficacy and Toxicity of Immune -Checkpoint Inhibitors in Patients With Preexisting Autoimmune Disorders

et al. 2020

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“…Autonomic symptoms were only detected after neurological examination and laboratory tests, and the patient had no other neurological symptoms, including sensory symptoms. With regard to autonomic symptoms, anti-Hu antibodies usually cause chronic gastrointestinal pseudo-obstruction or acute pandysautonomia as part of encephalomyelitis or subacute sensory neuropathy [ 6 , 7 , 10 , 11 ], whereas anti-gAchR antibodies are mainly associated with subacute pandysautonomia [ 1 , 4 , 6 ]. Anti-SOX-1 antibodies are also detected in Lambert-Eaton syndrome with SCLC [ 12 , 13 ].…”

Section: Discussionmentioning

confidence: 99%

“…These autonomic symptoms result in decreased Eastern Cooperative Oncology Group (ECOG) performance status (PS) and lead to out of indication for cancer therapy. Moreover, it may be overlooked in patients with lung cancer because autonomic PNS due to lung cancer is very rare [ 7 ]. Therefore, early diagnosis of PNS, immunotherapy and appropriate treatments for PNS are essential for improving the patient’s quality of life.…”

Section: Introductionmentioning

confidence: 99%

Integrated treatment for autonomic paraneoplastic syndrome improves performance status in a patient with small lung cell carcinoma: a case report

et al. 2018

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BackgroundParaneoplastic neurological syndromes (PNS) are rare disorders associated with cancer and are believed to be immune mediated. Patients with autonomic PNS suffer from variable combinations of parasympathetic and sympathetic failure. Autonomic PNS are usually associated with other PNS, such as encephalomyelitis and sensory neuropathy; however, autonomic symptoms may rarely manifest as PNS symptoms. Autonomic symptoms, therefore, may be overlooked in patients with cancer.Case presentationWe described a 65-year-old Japanese man who was diagnosed with autonomic PNS due to small-cell lung carcinoma (SCLC) with Eastern Cooperative Oncology Group (ECOG) performance status 3, who suffered from orthostatic hypotension, and urinary retention needing a urethral balloon. Laboratory studies showed decreased levels of noradrenaline, and were positive for anti-ganglionic acetylcholine receptor antibody, type 1 antineuronal nuclear antibody, and sry-like high mobility group box 1 antibody. Nerve conduction evaluations and 123I-metaiodobenzylguanidine myocardial scintigraphy showed no abnormalities. Abdominal contrast-enhanced computed tomography revealed marked colonic distention. The patient’s autonomic symptoms resolved following integrated treatment (symptomatic treatment, immunotherapy, and additional chemotherapy) enabling the patient to walk, remove the urethral balloon, and endure further chemotherapy. ECOG performance status remained at 1, 10 months after admission.ConclusionsIntegrated treatment for autonomic PNS may improve autonomic symptoms and ECOG performance status of patients with cancer.

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“…Recent research has shown that the manifestations of the PNS on the peripheral nervous system is most common in small-cell lung cancer 4,5 , although rare even in this type of cancer 6 . Contrary to patients in the early stages of the disease, if the frequency is examined in patients in late stages, the damage of the peripheral nervous system is present in as much as 15% of patients, where this is pathophysiologically explained as metabolic and nutritive deficiencies, and⁄or the effects of chemotherapy as part of the primary disease treatment 7 .…”

Section: Introductionmentioning

confidence: 99%

Clinical and electrophysiological features of peripheral neuropathy in older patients with lung carcinoma

Tomanovic-Vujadinovic

Jovanović

Ilić

et al. 2020

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Background/Aim. Peripheral nervous system affection in people with lung cancer is commonly associated with paraneoplastic neuropathy. However, clinical studies evaluating the frequency, clinical, and electrophysiological characteristics of peripheral neuropathies which are not related to onconeuronal antibodies, in this, on average, older population of patients, are very rare. The aim of this study was to define the frequency, as well as clinical and electrophysiological characteristics of idiopathic neuropathies in patients suffering from lung cancer in early stages of the diseases. Methods. Clinical and electrophysiological data of 105 elderly subjects (age 63.4 ± 7.8 years) suffering from lung carcinoma who underwent extensive neurological and electrophysiological evaluation (nerve conduction studies) between 2013-2018 were estimated. Exclusion criteria were "classical" paraneoplastic neurological syndromes with onconeuronal antibodies present, as well as patients with typical known causes of peripheral neuropathy (e.g. diabetes, alco-kom lečenja bolesnici podrgavaju nizu tretmana sa dodatnim rizikom od razvoj/pogoršanja neuropatija Ključne reči: pluća, neoplazme; plineuropatije; komorbiditet; stare osobe; elektrofiziologija.

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Autoimmune paraneoplastic syndromes associated to lung cancer: A systematic review of the literature Part 4: Neurological paraneoplastic syndromes, involving the peripheral nervous system and the neuromuscular junction and muscles

Cited by 7 publications

References 219 publications

Efficacy and Toxicity of Immune -Checkpoint Inhibitors in Patients With Preexisting Autoimmune Disorders

Efficacy and Toxicity of Immune -Checkpoint Inhibitors in Patients With Preexisting Autoimmune Disorders

Integrated treatment for autonomic paraneoplastic syndrome improves performance status in a patient with small lung cell carcinoma: a case report

Clinical and electrophysiological features of peripheral neuropathy in older patients with lung carcinoma

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