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Severe meningo-radiculo-nevritis associated with ipilimumab

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Summary

Purpose Ipilimumab is a T-cell-potentiating monoclonal antibody directed against cytotoxic T-lymphocyte antigen-4 (CTLA-4) to promote antitumoural immunity. In phase III trials, ipilimumab was shown to be the first agent to improve survival in advanced melanoma patients, regardless of previous treatment. We report a case of severe neurologic disease after ipilimumab treatment. Patient and methods Neurologic symptoms including facial diplegia, tetraplegia, areflexia progressed with time a few days after the fourth monthly ipilimumab infusion. Analysis of the cerebro-spinal fluid showed elevated proteinorachy and lymphocytic meningitis. Despite high doses of steroids and symptomatic treatment, the symptoms worsened. Results Veinoglobulins were then infused and the patient began to improve and recovered almost normal activity two years later. Conclusion The adverse event profile associated with ipilimumab was primarily immune-related. This is the first case in which such a severe event has been reported.

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Conflict of interest

Caroline Robert declares consulting activities for Bristol-Myers Squibb.

The other authors declare that they have no conflict of interest.x

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Authors and Affiliations

  1. Service de neurologie, Hôpital d’instruction des armées du Val de Grâce, Service de santé des Armées, Paris, France

    Flavie Bompaire, Hervé Taillia, Thierry De Greslan, Magali Sallansonnet-Froment, Madani Ouologuem, Jean-Luc Renard & Damien Ricard

  2. Ecole du Val de Grâce, Service de Santé des Armées, Paris, France

    Flavie Bompaire, Hervé Taillia & Damien Ricard

  3. Service de radiologie, Hôpital d’instruction des armées du Val de Grâce, Service de santé des Armées, Paris, France

    Marion Lahutte

  4. Service de dermatologie, département d’oncologie médicale, Institut Gustave Roussy, Villejuif, France

    Christine Mateus & Caroline Robert

  5. INSERM U981, Institut Gustave Roussy, Villejuif, France

    Caroline Robert

  6. Laboratoire d’Immunologie, Hôpital de la Pitié Salpêtrière, Paris, France

    Guy Gorochov

  7. Service de neurologie HIA du Val de Grâce, 74 boulevard de Port Royal, Paris, France

    Damien Ricard

  8. Université Pierre et Marie Curie, Paris, France

    Guy Gorochov

Authors
  1. Flavie Bompaire
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  2. Christine Mateus
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  3. Hervé Taillia
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  4. Thierry De Greslan
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  5. Marion Lahutte
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  6. Magali Sallansonnet-Froment
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  7. Madani Ouologuem
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  8. Jean-Luc Renard
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  9. Guy Gorochov
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  10. Caroline Robert
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  11. Damien Ricard
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Corresponding author

Correspondence to Damien Ricard.

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Bompaire, F., Mateus, C., Taillia, H. et al. Severe meningo-radiculo-nevritis associated with ipilimumab. Invest New Drugs 30, 2407–2410 (2012). https://doi.org/10.1007/s10637-011-9787-1

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  • DOI: https://doi.org/10.1007/s10637-011-9787-1

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