Acute demyelinating polyneuropathy induced by nivolumab

Nivolumab is a monoclonal antibody to programmed cell death-1 (PD-1) protein and acts as an immune checkpoint inhibitor by disrupting the interaction of the PD-1 receptor with its ligands. Nivolumab has emerged as an effective treatment for advanced cancers such as melanoma and non-small cell lung cancer (NSCLC). However, immune-related adverse events (irAEs) are sometimes associated with the administration of immune checkpoint inhibitors. Colitis, endocrine dysfunction and myasthenia gravis (MG) are well-known irAEs induced by nivolumab. Here, we report a case of nivolumab-induced acute demyelinating polyneuropathy.

Case report 

A 66-year-old man was diagnosed with NSCLC and developed adrenal metastases. Although the patient was treated with two courses of carboplatin [AUC (area under the curve) 6] and nab-paclitaxel (100 mg/m²), bilateral swelling of cervical lymph nodes and adrenal metastatic lesions expanded, and he received nivolumab treatment. Five days after two courses of nivolumab treatment, he developed muscle weakness of the lower limbs (day...

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