Navigating Neurologic Adverse Events in Immune Checkpoint Inhibitor Therapy: Challenges and Strategies

The advancement of immunotherapy has changed cancer treatment. Immune checkpoint inhibitors (ICIs) are one of the groundbreaking immunotherapies that have offered patients with advanced cancer new optimism by utilizing the immune system's innate ability to fight cancer with amazing success. Nevertheless, this exceptional approach has drawbacks, including the range of immune-related adverse events (irAEs) that can arise due to ICI therapy. IrAEs that impact various parts and systems of the body can be particularly problematic, and can be difficult to identify and manage. Neurological side effects of ICIs are of particular interest, as they may vary from minor sensory issues to possibly fatal neuroinflammatory reactions. The purpose of this review is to elucidate the peculiarities of neurological immune-related adverse events (n-irAEs) associated with ICIs and to provide a complete overview of the various facets of ICI therapy by exploring the mechanisms, clinical manifestations, and management strategies of n-irAEs. Furthermore, it is crucial to emphasize the importance of caution, early recognition, and collaboration between oncologists and neurologists to optimize patient outcomes while overcoming the challenges posed by these enigmatic neurologic complications.