Neurological Complications of Targeted Therapies and Immunotherapies for Cancer

Abstract

Targeted therapies and immunotherapies for cancer are associated with a wide spectrum of neurological complications. This review summarizes the neurological toxicity associated with some of the most recently FDA-approved agents or indications. Neurological complications of oral small molecule inhibitors are generally rare or mild, though some recently approved receptor tyrosine kinase inhibitors display significant central nervous system toxicities. Immune checkpoint inhibitors are associated with many neurological adverse events, some fatal, and consensus guidelines have been established in regard to managing these complications. Finally, chimeric antigen receptor T cell therapy revolutionized the treatment of relapsed refractory leukemia and lymphoma but is associated with an immune effector cell-associated neurotoxicity syndrome. This review focuses on the characterization of neurotoxicities from targeted therapies and immunotherapies and recently reviewed recommendations for management. The neurological complications of new cancer therapies are a complex and rapidly evolving field though ongoing studies are shedding light on the mechanisms and best supportive care for these toxicities.