Affiliations: [a] Department of Neurological Sciences, Rush University Medical Center, Chicago, IL, USA
| [b] Section of Medical Oncology, Rush University Medical Center, Chicago, IL, USA
Correspondence:
[*]
Correspondence to: Dana S. Cooper, Department of Neurological Sciences, Rush University Medical Center, Professional Building, 1725 W Harrison St. Suite 1118, Chicago, IL 60612, USA. Tel.: +1 312 942 4500; Fax: +1 312 942 2380; E-mail: dana_s_cooper@rush.edu.
Abstract: Monoclonal antibodies that target either PD-1 or PD-L1 have recently been approved for treatment of advanced non-small cell lung cancer. These antibodies are immune checkpoint inhibitors which have been shown to exacerbate Myasthenia Gravis (MG) and other autoimmune diseases. While effective in preventing tumor cells from evading immune attack, immune checkpoint inhibitors such as nivolumab, an antibody directed against the programmed cell death protein-1 (PD-1) receptor located on T-cells, may also cause immune dysregulation and could cause or potentiate pre-existing autoimmune conditions. We present a patient with latent ocular MG treated with nivolumab for her stage IV non-small cell lung cancer who developed generalized MG and severe myasthenic crisis. Providers must be aware of the risks inherent to these novel therapies since they can have life-threatening effects.
