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The aim of this study was to characterize irAEs involving the peripheral nervous system (PNS-irAEs) in a real-world cohort of ICI-treated patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Cancer patients treated with ICIs between January 2014 and March 2022 were included. Patients with PNS-irAEs were identified and divided into two groups: (1) cranial\/peripheral neuropathies and (2) myasthenia gravis (MG) and\/or myositis. Clinical characteristics and outcomes, measured with the modified Rankin Scale (mRS), were compared among the two groups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 920 ICI-treated patients, 20 patients (2.17%) developed a PNS-irAEs. The median latency from ICI exposure was 8.8\u00a0weeks and the median time from onset to clinical nadir was 3.5\u00a0weeks. Eleven patients developed a neuropathy: polyneuropathy (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20094), cranial neuropathy (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20093), small-fiber neuropathy (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20093), brachial plexopathy (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20091). Nine patients presented MG and\/or myositis: concomitant MG and myositis (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20096), isolated myositis (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20092), exacerbation of MG (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20091). Immunosuppressive treatment and\/or ICI withdrawal determined a significant clinical improvement, expressed by a mRS reduction, in the neuropathy group (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.004), but not in the MG\/myositis group (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.11). Overall, death due to irAEs occurred in four patients (20%), all with MG\/myositis. Compared to patients with neuropathies, those with MG\/myositis had a shorter latency onset (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.036), developed more frequently concomitant non-neurologic irAEs (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.028) and showed a higher mortality rate (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.026).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In our large cohort of ICI-treated patients, 2.17% developed PNS-irAEs. Compared to ir-neuropathies, ir-MG\/myositis tend to occur earlier from ICI exposure and present a worse response to treatment and a higher mortality.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00415-023-11625-1","type":"journal-article","created":{"date-parts":[[2023,2,17]],"date-time":"2023-02-17T11:52:30Z","timestamp":1676634750000},"page":"2975-2986","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":49,"title":["Peripheral nervous system adverse events associated with immune checkpoint inhibitors"],"prefix":"10.1007","volume":"270","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7044-983X","authenticated-orcid":false,"given":"Simone","family":"Rossi","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Gelsomino","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rita","family":"Rinaldi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lorenzo","family":"Muccioli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesca","family":"Comito","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessandro","family":"Di Federico","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"De Giglio","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giuseppe","family":"Lamberti","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elisa","family":"Andrini","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Veronica","family":"Mollica","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roberto","family":"D\u2019Angelo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Flavia","family":"Baccari","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Corrado","family":"Zenesini","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pierandrea","family":"Madia","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emanuel","family":"Raschi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pietro","family":"Cortelli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Ardizzoni","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Guarino","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2023,2,17]]},"reference":[{"key":"11625_CR1","doi-asserted-by":"publisher","DOI":"10.1038\/s41467-020-17670-y","author":"C Robert","year":"2020","unstructured":"Robert C (2020) A decade of immune-checkpoint inhibitors in cancer therapy. 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Dr. Francesco Gelsomino reports personal fees from AstraZeneca and honoraria for advisory board participation from Eli-Lilly. The other authors have no conflict of interest to declare.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflicts of interest"}},{"value":"The study has been approved by the local ethics committee (Comitato Etico Area Vasta Emilia Centro, CE-AVEC) and has been performed in accordance with the Declaration of Helsinki and its later amendments.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical standard statement"}},{"value":"Informed consent was obtained from all individual participants included in the study.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent to participate"}},{"value":"The participants have consented to the submission of the case report to the journal.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent to publish"}}]}}