Relapse, disease progression uncommon with immune checkpoint inhibitors in MS

Key takeaways:

• Chart review yielded 38 persons with MS and cancer treated with immune checkpoint inhibitors.
• Thirteen patients treated with ICIs had partial or complete cancer remission at final follow-up.

DENVER – For older adults with MS and signs of cancer, treatment with immune checkpoint inhibitors was safe and prevented relapse or disease progression, according to interim research.

“[Multiple sclerosis] features an array of neurologic symptoms and with age comes a higher incidence of cancer,” Prashanth Rajarajan, MD, PhD, neurology resident at Mass General Brigham and Women’s Hospital, said in an AAN-sponsored press conference held prior to its annual meeting. “This newer line of treatment, called immune checkpoint inhibitors, unlock the immune system’s ability to attack the tumor.”

Rajarajan and colleagues attempted to define MS disease activity and subsequent neurological outcomes following exposure to these immune checkpoint inhibitors (ICIs) as a cancer treatment because previous reports showed ICIs demonstrated a possible risk of immune-related adverse events and relapse triggering in those dealing with the autoimmune condition.

Their retrospective chart review culled data from eight tertiary medical systems, with structured instrument analysis including MS/cancer histories, treatment and outcomes to yield 38 individuals (median age 66 years; 71% female) treated with ICIs. A total of 13 individuals were on disease-modifying therapies (DMTs) before ICI initiation, with eight of those continuing DMTs during ICI therapy. Additionally, the most common tumors found in the study population were lung (n = 11) and melanoma (n = 10).

According to interim results, one participant suffered a relapse following ICI treatment, with one other recorded with ongoing disease progression over a mean 13-month follow-up interval. Although 13 participants were found to have either partial or complete cancer remission at last follow-up, 12 logged non-neurologic adverse events and two others recorded peripheral nervous system immune-related adverse events with ICI treatment.

“Overall, our data are reassuring, evidenced by oncologists and neurologists getting patients with MS the treatment that they need,” Rajarajan said.