Rinsho Shinkeigaku (Clinical Neurology)

Case Report

Atezolizumab-induced Guillain-Barré syndrome-like acute demyelinating polyneuropathy responsive to steroid therapy: a case report

Nanami Yamanaka, M.D.1), Mariko Oishi, M.D., Ph.D.1), Fumitaka Shimizu, M.D., Ph.D.1), Michiaki Koga, M.D., Ph.D.1) and Takashi Kanda, M.D., Ph.D.1)

1) Department of Neurology and Clinical Neuroscience, Yamaguchi University Graduate School of Medicine

A 76-year-old man, who received atezolizumab for the treatment for small cell lung cancer, acutely developed limb weakness with sensory disturbance after the third course of the treatment. Nerve conduction studies were consistent with demyelinating polyneuropathy and acute demyelinating polyneuropathy caused by atezolizumab was suggested. Atezolizumab was immediately withdrawn, and intravenous immunoglobulin (IVIg) and methylprednisolone pulse therapies with subsequent oral administration of prednisolone were initiated, after which neurological deficits steadily improved. Although Guillain-Barré syndrome-like neuropathy caused by immune checkpoint inhibitor (ICI) was occasionally reported, this is the first case of acute demyelinating polyneuropathy triggered by atezolizumab, monoclonal antibody targeting programmed death-ligand 1. This case suggests that combined treatments with IVIg and corticosteroids are effective for neuropathy induced by atezolizumab as same as those by other ICI.
Full Text of this Article in Japanese PDF (554K)

(CLINICA NEUROL, 61: 653−657, 2021)
key words: acute demyelinating polyneuropathy, immune-related adverse events, programmed death-ligand 1, atezolizumab, small cell lung cancer

(Received: 29-Oct-20)