Cetuximab-induced aseptic meningitis: case report and review of a rare adverse event

Maritaz, Christophe; Metz, Carole; Baba-Hamed, Nabil; Jardin-Szucs, M.; Deplanque, Gaël

doi:10.1186/s12885-016-2434-7

Cited by 14 publications

(12 citation statements)

References 12 publications

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“…Existing case reports of aseptic meningitis have similarities to our patient: she is within a similar age range, presented several hours after administration of cetuximab, had non-specific CSF abnormalities, and recovered in a relatively short time period to her baseline status. 4–9 However, there are some unique characteristics that make this case, to our knowledge, the first of its kind. First, our patient was being treated for metastatic colon cancer.…”

Section: Discussionmentioning

confidence: 97%

A case of aseptic meningitis in a cetuximab-experienced patient with metastatic colon cancer

Rohrer

Grullon

George

et al. 2017

J Oncol Pharm Pract

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Cetuximab is a monoclonal antibody against epidermal growth factor receptor and is used in the treatment of head and neck cancer, non-small cell lung cancer, and colorectal cancer. This case report describes a rare (<1% incidence) side effect of cetuximab administration: aseptic meningitis. We report a case which is, to our knowledge, the only case at the time of submission of this manuscript of aseptic meningitis in a patient being treated for metastatic colon cancer who was not cetuximab-naïve. This case report may help inform clinicians about the identification and outcome of this adverse event.

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Section: Discussionmentioning

confidence: 97%

A case of aseptic meningitis in a cetuximab-experienced patient with metastatic colon cancer

Rohrer

Grullon

George

et al. 2017

J Oncol Pharm Pract

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“…For example, nonsteroidal anti-inflammatory drugs have been associated with many adverse drug reactions mainly involving the gastrointestinal tract and liver, but also with drug-induced aseptic meningitis with the presence of neutrophilic or lymphocytic pleocytosis in CSF. 26 Drug-induced aseptic meningitis, although rare, has in addition been associated with antimicrobials (ie, cetuximab) 27,28 and trimethoprim/sulfamethoxazole 29,30 as well as intravenous immunoglobulins, 31 monoclonal antibodies, 32 and vaccines. 33 Across all 3 species in this study, lymphocytes and monocytoid cells represented approximately 90% of the cellular differential.…”

Section: Discussionmentioning

confidence: 99%

Cerebrospinal Fluid Characterization in Cynomolgus Monkeys, Beagle Dogs, and Göttingen Minipigs

et al. 2020

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Intrathecal administration is an important route for drug delivery, and in pharmacology and toxicology studies, cerebrospinal fluid (CSF) collection and analysis is required for evaluating blood–brain barrier penetration and central nervous system exposure. The characteristics of CSF in commonly used nonrodent models are lacking. The purpose of this study is to evaluate and provide some insights into normal cellular and biochemical composition of CSF as well as diffusion potential following intrathecal injection across several nonrodent species. Cerebrospinal fluid samples were collected from the cerebellomedullary cistern of beagle dogs, cynomolgus monkeys, and Göttingen minipigs and analyzed for clinical chemistry and cytological evaluation. Diffusion into the intrathecal space following intrathecal injection was assessed following administration of a contrast agent using fluoroscopy. The predominant cell types identified in CSF samples were lymphocytes and monocytoid cells; however, lymphocytes were represented in a higher percentage in dogs and monkeys as opposed to monocytoid cells in minipigs. Clinical chemistry parameters in CSF revealed higher Cl− concentrations than plasma, but lower K+, Ca2+, phosphorus, glucose, creatinine, and total protein levels consistent across all 3 species. Diffusion rates following intrathecal injection of iodixanol showed some variability with dogs, showing the greatest diffusion distance; however, the longest diffusion time through the intervertebral space, followed by monkeys and minipigs. Minimal diffusion was observed in minipigs, which could have been attributed to anatomical spinal constraints that have been previously identified in this species.

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“…Aseptic meningitis has been noted in several different immunotherapeutic agents, such as cetuximab [ 93 ], pembrolizumab, nivolumab [ 94 ], and ipilimumab [ 95 ]. Meningitis was more likely to present with additional non-neurologic immune-related adverse effects.…”

Section: Neurotoxic Features Of Immunotherapymentioning

confidence: 99%

Neurotoxicity of Tumor Immunotherapy: The Emergence of Clinical Attention

Zhang

Xue

Yin

et al. 2022

Journal of Oncology

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Tumor immunotherapy brings substantial and long-term clinical benefits that can even cure tumors. However, the accumulation of evidence suggests that immunotherapy also induces severe and complex neurologic immune-related adverse events (ir-AEs) and even leads to immunotherapy-related death, which arouses the concern of clinicians. The timely and accurate identification of neurotoxicity helps clinicians detect and treat these complications early, thereby enhancing treatment efficiency and improving the prognosis of patients. At present, the mechanism of neurotoxicity caused by immunotherapy has not been completely elucidated. This paper mainly reviews the clinical features, pathogenesis, and therapeutic strategies of neurologic ir-AEs.

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Cetuximab-induced aseptic meningitis: case report and review of a rare adverse event

Cited by 14 publications

References 12 publications

A case of aseptic meningitis in a cetuximab-experienced patient with metastatic colon cancer

A case of aseptic meningitis in a cetuximab-experienced patient with metastatic colon cancer

Cerebrospinal Fluid Characterization in Cynomolgus Monkeys, Beagle Dogs, and Göttingen Minipigs

Neurotoxicity of Tumor Immunotherapy: The Emergence of Clinical Attention

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