Article Open Access Volume 3 · Issue 3 · 2023 pp. 149–151

Myastenic Syndrome Diagnosed After Treatment of Small Cell Lung Cancer with Atezolizumab (PDL-1 Inhibitor)

Bala Başak Öven1, İrem Türkmen2, Ipek Geyikoğlu3, Serkan Çelik1, Lidya Aden Çağlar4
1 Department of Medical Oncology, Yeditepe University Hospital, Istanbul, Türkiye
2 Department of Cardiology, Mehmet Akif Ersoy Cardiothoracic Surgery Research and Training Hospital, Istanbul, Türkiye
3 Department of Obstetrics and Gynecology, Basaksehır Cam Sakura Research and Training Hospital, Istanbul, Türkiye
4 Department of Internal Medicine, Yeditepe University Hospital, Istanbul, Türkiye
Published: 2023 DOI: 10.14744/ejma.2023.47966 Article ID: EJMA-47966
Abstract
Immune checkpoint inhibitors have been increasingly used for many type of solid tumor, first line treatment of small cell lung cancer (SCLC) with chemotherapy combination with atezolizumab is one of them. Although usually well tolerated, autoimmune related side effects can be seen.We report of autoimmune myasetnia gravis that occured after treatment of atezolizumab, an anti-programmed-death (anti-PD-1) monoclonal antibody.
Our patient is 71 year old woman with extensive stage small cell lung cancer receiving chemotherapy combined with atezolizumab. Although good oncological response to treatment after 8 cycle of atezolizumab, myastenia gravis was occured. This automimmune neurological syndrome is likely associated with atezolizumab treatment, patient had no any neurological disorder before. Symptoms were partially responded after steroid, piridostigmine and iv-ig therapy.
The number of the patient that treated with immunotherapy will increase in the future so it should be important to know the adverse effects management of immunotherapy.

Keywords: Myastenia gravis, atezolizumab, immunotherapy

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