Impact of Immune Checkpoint Inhibitors on Multiple Sclerosis Treatment Outcomes

A group of researchers evaluated the effects of immune checkpoint inhibitors (ICIs) on multiple sclerosis (MS) disease activity and neurologic outcomes in patients with MS who received these cancer therapies. ICIs are known to cause immune-related adverse events (AEs) and may exacerbate preexisting autoimmune conditions. Although there are reports of ICIs triggering MS relapses, the overall incidence of ICI-induced MS activity remains unclear.

For the study, researchers conducted a chart review across 8 tertiary medical systems, identifying 38 patients with MS (predominantly female; median age, 66 years). Most had relapsing-remitting MS, with 13 patients on disease-modifying therapies (DMT) prior to ICI treatment. The common primary cancers among the patients included lung cancer and melanoma.

The results showed that over an average follow-up of 13 months, only 1 patient experienced a relapse post-ICI treatment, and 1 patient showed ongoing disease progression. A small percentage (5%) reported peripheral nervous system immune-related AEs, while a larger group (32%) had non-neurologic immune-related AEs. Notably, 13 (34%) of the patients achieved partial or complete remission of their cancer.

The findings suggest that relapses and progression of MS in patients undergoing ICI treatment are rare, particularly among older patients not on DMT. This interim analysis highlights the need for further research to better understand the relationship between ICIs and MS disease activity.

Reference

Quinn C, Rajarajan P, Kopinsky H, et al. Multi-institutional study of neurologic outcomes in people with multiple sclerosis who are treated with immune checkpoint inhibitors for oncologic indications.  Presented at: the American Academy of Neurology 2024 Annual Meeting; October 25-27, 2024; Paradise, NV; Abstract PL4.002.