The neurooncology research group of IDIBELL, Bellvitge University Hospital and the ICO has described in a study published in the prestigious journal JAMA Neurology two different clinical patterns of encephalitis that occur as a side effect of a cancer treatment with immunotherapy.
This work will help to make an early diagnosis and improve the treatment of patients who have side effects from oncological immunotherapies.
Immunotherapy is an innovative type of cancer treatment that restores or intensifies the immune system's ability to fight cancer. Unlike chemotherapy or radiation therapy, it is a specific treatment that targets very specific parts of the cells. In addition, it is a type of therapy that generates immune memory that can be very useful if the cancer reappears a few years later. However, as with other types of treatments, it is not free of possible side effects.
In 2-6% of cases, immunotherapies with inhibitors of immune control points have neurological repercussions, including inflammation of the brain or encephalitis. To date, the clinical features of these encephalitis have not been systematically studied.
The neurooncology research group, led by Dr. Jordi Bruna, coordinator of the Functional Unit of Neurooncology HUB-ICO, together with the CRES (Clinical Research in Solid Tumors) of IDIBELL, has characterized this complication with the analysis of their own cases and a systematic review of those published in the medical literature. The study concluded that this inflammation of the brain can manifest itself according to two different patterns, each with a specific prognosis.
A first group of patients present with diffuse inflammation of the brain and meninges which results in headache, fever and language impediments. These patients usually have a favorable prognosis.
A second group develops more aggressive syndromes focused on specific regions of the brain. If this is combined with the presence of autoantibodies in the cerebrospinal fluid, the prognosis is very unfavorable.