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01-07-2020 | Radioimmunotherapy | Case Study

An autoimmune-based, paraneoplastic neurologic syndrome following checkpoint inhibition and concurrent radiotherapy for merkel cell carcinoma: case report

Authors: Alexander D. Sherry, Michael Bezzerides, Mohamed H. Khattab, Guozhen Luo, Kristin K. Ancell, Austin N. Kirschner, MD, PhD

Published in: Strahlentherapie und Onkologie | Issue 7/2020

Abstract

Purpose

Merkel cell carcinoma is highly sensitive to both radiation and immunotherapy. Moreover, concurrent radioimmunotherapy may capitalize on anti-tumor immune activity and improve Merkel cell treatment response, although an enhanced immune system may cross-react with native tissues and lead to significant sequelae.

Methods

Here we present a case study of a patient with metastatic Merkel cell carcinoma treated with radiotherapy concurrent with pembrolizumab.

Results

After radioimmunotherapy, the patient developed sensory neuropathy, visual hallucinations, and mixed motor neuron findings. Neurologic dysfunction progressed to profound gastrointestinal dysmotility necessitating parenteral nutrition and intubation with eventual expiration.

Conclusion

This case represents a unique autoimmune paraneoplastic neurologic syndrome, likely specific to neuroendocrine tumors and motivated by concurrent radioimmunotherapy. Recognition of the potential role of radioimmunotherapy may provide an advantage in anticipating these severe sequelae.

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Title: An autoimmune-based, paraneoplastic neurologic syndrome following checkpoint inhibition and concurrent radiotherapy for merkel cell carcinoma: case report
Authors: Alexander D. Sherry
Michael Bezzerides
Mohamed H. Khattab
Guozhen Luo
Kristin K. Ancell
Austin N. Kirschner, MD, PhD
Publication date: 01-07-2020
Publisher: Springer Berlin Heidelberg
Keywords: Radioimmunotherapy
Merkel Cell Carcinoma
Radiotherapy
Paraneoplastic Neurologic Syndrome
Published in: Strahlentherapie und Onkologie / Issue 7/2020
Print ISSN: 0179-7158
Electronic ISSN: 1439-099X
DOI: https://doi.org/10.1007/s00066-020-01582-3

ACC 2024 Congress

Springer Medicine

An autoimmune-based, paraneoplastic neurologic syndrome following checkpoint inhibition and concurrent radiotherapy for merkel cell carcinoma: case report

Abstract

Purpose

Methods

Results

Conclusion

ACC 2024 Congress

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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