PT  - JOURNAL ARTICLE
AU  - Orcurto, Angela
AU  - Hottinger, Andreas
AU  - Wolf, Benita
AU  - Navarro Rodrigo, Blanca
AU  - Ochoa de Olza, Maria
AU  - Auger, Aymeric
AU  - Kuntzer, Thierry
AU  - Comte, Denis
AU  - Zimmer, Virginie
AU  - Gannon, Philippe
AU  - Kandalaft, Lana
AU  - Michielin, Olivier
AU  - Zimmermann, Stefan
AU  - Harari, Alexandre
AU  - Trueb, Lionel
AU  - Coukos, George
TI  - Guillain-Barré syndrome after adoptive cell therapy with tumor-infiltrating lymphocytes
AID  - 10.1136/jitc-2020-001155
DP  - 2020 Aug 01
TA  - Journal for ImmunoTherapy of Cancer
PG  - e001155
VI  - 8
IP  - 2
4099  - http://jitc.bmj.com/content/8/2/e001155.short
4100  - http://jitc.bmj.com/content/8/2/e001155.full
SO  - J Immunother Cancer2020 Aug 01; 8
AB  - Background Adoptive cell therapy (ACT) using tumor-infiltrating lymphocytes (TILs) is a promising experimental immunotherapy that has shown high objective responses in patients with melanoma. Current protocols use a lymphodepletive chemotherapy before infusion of ex vivo expanded TILs, followed by high-dose interleukin-2 (IL-2). Treatment-related toxicities are mainly attributable to the chemotherapy regimen and to the high-dose IL-2 and are generally reversible. Neurological side effects have rarely been described. Nevertheless, due to improvements in cell production techniques and due to combinations with other immunomodulating molecules, side effects not previously described may be encountered.Case presentation We report the case of a 53-year-old heavily pretreated patient with melanoma who developed Guillain-Barré syndrome (GBS) 19 days after ACT using autologous TILs, given in the context of a phase I trial. He presented with dorsal back pain, unsteady gait and numbness in hands and feet. Lumbar puncture showed albuminocytological dissociation, and nerve conduction studies revealed prolonged distal motor latencies in median, ulnar, tibial and peroneal nerves, compatible with a GBS. The patient was treated with intravenous immunoglobulins and intensive neurological rehabilitation, with progressive and full recovery at 21 months post-TIL-ACT. Concomitant to the onset of GBS, a cytomegalovirus reactivation on immunosuppression was detected and considered as the most plausible cause of this neurological side effect.Conclusion We describe for the first time a case of GBS occurring shortly after TIL-ACT for melanoma, even though we could not identify with certainty the triggering agent. The report of such rare cases is of extreme importance to build on the knowledge of immune cellular therapies and their specific spectrum of toxicities.