Pembrolizumab-induced Guillain-Barré syndrome in triple-negative breast cancer: A case report

Table 1 Review of literature on cases of pembrolizumab-induced Guillain-Barré syndrome

Ref.	Age	Sex	Cancer type	Associated treatment	Onset of GBS after the initiation of treatment in weeks	Treatment of GBS	Neurologic recovery
Han et al[2]	55	Male	Advanced renal cell carcinoma with sarcomatoid differentiation	Sunitinib	16	Oral dexamethasone and then switched to IVIG 0.4 g/kg for 5 days along with prednisone 1 mg/kg per day followed by a taper	Symptoms improved during 1 week of treatment; after 1 month, walking and standing was normal
Ding et al[15]	58	Male	Squamous cell carcinoma of the lung	KN046, a PD-L1/CTLA-4 bispecific antibody	3	Methylprednisolone 500 mg plus IVIG 0.4 g/kg/day for 3 days with no improvement; MM capsules 500 mg twice a day for 3 days with significant improvement	Favorable
Perrod et al[16]	69	Male	Advanced duodenal adenocarcinoma	None	4	IVIG 2 mg/kg for 3 days and IV methylprednisolone 240 mg for 5 days, followed by oral prednisolone 80 mg per day	Favorable
Brzezinska et al[17]	72	Female	Endometrial adenocarcinoma	Lenvatinib	1	Methylprednisolone 1 g IV daily for 5 days and IVIG 2 g/kg over 5 days	Favorable
Oguri et al[18]	76	Male	Stage IV lung adenocarcinoma	None	3	Prednisolone 1 mg/kg followed by IVIG therapy 400 mg/kg/day	Death from respiratory failure on day 53
Sangani et al[19]	80	Male	Metastatic bladder cancer to bones and retroperitoneal lymph nodes	None	1	IVIG for 5 days plus continued physical therapy	Favorable
Aoki et al[20]	85	Female	Metastatic urothelial carcinoma	None	18	Methylprednisolone 80 mg/day followed by oral prednisolone 30 mg/day taper	Favorable
Muralikrishnan et al[21]	65	Female	Malignant melanoma	None	4	IVIG over 5 days for the first time; PE for 7 days and solumedrol for 5 days instead of IVIG for reoccurrence	Relapsed, ongoing bilateral leg tingling and diarrhea
Arora et al[22]	70	Male	Melanoma and prostate cancer	None	12	Dexamethasone for 6 days and IVIG for 5 days	Hydrocephalus, ventricular enlargement; bed-bound; death upon withdrawal from life support
Ong et al[23]	66	Male	Lung adenocarcinoma	None	6.5	Methylprednisone and IVIG, prednisone	Favorable; mild residual paresthesia of the feet
Manam et al[24]	73	Male	Lung adenocarcinoma	None	3	Methylprednisolone along with IVIG, PE	Favorable
Manam et al[24]	81	Male	Melanoma	None	10	Methylprednisolone along with IVIG for 5 days, PE	Death from respiratory failure
de Maleissye et al[25]	85	Female	Metastatic melanoma	None	9	Prednisolone, IVIG	Favorable
Janssen et al[4]	74	Male	Prostate cancer	None	6	Prednisolone, IVIG PE	Death from pneumonia
Janssen et al[4]	55	Male	Melanoma	None	16	Prednisolone, IVIG, methylprednisolone	Mild persistent weakness of feet extensors and mild sensory loss and ataxia
Hashimoto et al[26]	72	Male	Non-small cell lung cancer	None	1.5	Corticosteroids and immunoglobulin therapy	Undescribed
Pomerantz et al[27]	58	Male	Squamous cell carcinoma of the lung	Nivolumab	8.4	IVIG for 5 days	Rehabilitation; no other potential agents were given; patient was alive 6 months after the use of last immunotherapies

GBS: Guillain-Barré syndrome; IVIG: Intravenous immunoglobulin; PD-L1: Programmed death receptor-ligand 1; CTLA-4: Cytotoxic T-lymphocyte associated protein 4; IV: Intravenous; MM: Mycophenolate mofetil; PE: Plasma exchange.