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The following is a summary of “Neurologic Outcomes in People With Multiple Sclerosis Treated With Immune Checkpoint Inhibitors for Oncologic Indications,” published in the November 2024 issue of Neurology by Quinn et al.   

Immune checkpoint inhibitors (ICIs) are increasingly used in cancer treatment, but their safety in people with multiple sclerosis (MS) remains underexplored due to limited clinical trial data.  

Researchers conducted a retrospective study to assess the rate of MS activity and immune-related adverse events (irAEs) in people with MS treated with ICIs for cancer.  

They invited participating sites through the Medical Partnership 4 MS+ listserv, 7 large academic centers systematically searched the electronic medical record systems for patients with MS and a history of ICI treatment. Neurologists reviewed each chart individually to ensure that inclusion criteria were met. Data on demographics, MS and cancer history, treatments, and outcomes were abstracted using a structured instrument.  

The results showed 66 participants with MS (median age 66 years, 73% female, 68% not on disease-modifying therapy for MS), treated with ICIs for lung cancer (35%), melanoma (21%), or other oncologic indications, 2 patients (3%) experienced relapse or MRI activity. Additionally, 3 patients (5%) had neurologic irAEs, while 21 (32%) had nonneurologic irAEs. At the last follow-up (median: 11.7 months, range 0.2–106.3 months), 25 participants (38%) had partial or complete remission of their cancer, while 35 (53%) decreased.  

They concluded that older individuals with preexisting MS can still receive ICIs in cancer treatment, however, further research is needed for younger adults with MS. 

Source: neurology.org/doi/10.1212/WNL.0000000000210003