Encephalitis in a Patient With Melanoma Treated With Immune Checkpoint Inhibitors: Case Presentation and Review of the Literature

Abstract

After the approval of immune checkpoint inhibitors for the treatment of many solid tumors, a new class of adverse events was recognized through the augmented activation of T cells, known as immune-related toxicities (immune-related adverse events). Encephalitis as an immune-mediated phenomenon is extremely rare, but potentially fatal, and questions remain with regard to its optimal management. Herein, we describe a patient with metastatic melanoma who developed autoimmune encephalitis following treatment with nivolumab plus ipilimumab and present the data concerning clinical features, diagnostic procedure, and therapeutic management of neurological immune-related adverse events. Early recognition and management, and high doses of immunosuppressive agents are the proposed essential strategies for patients’ recovery. As immune-related toxicities may represent a clinical biomarker for cancer response to immune checkpoint inhibitors, these adverse events should promptly be managed to ensure that patients will experience the benefits of cancer immunotherapy.