Immune-related GFAP-Astrocytopathy under PD-1 inhibition: A case report

Abstract

Immune checkpoint inhibitors have substantially improved survival in advanced melanoma but are also associated with immune-related adverse events. Such events can affect any organ, including the central and peripheral nervous systems. Neurological adverse events are rare and often underrecognized. We report the case of a 53-year-old woman with melanoma who developed a severe neurological adverse event after treatment with the PD-1 inhibitor nivolumab. We describe a rare case of nivolumab-associated glial fibrillary acidic protein astrocytopathy and highlight the diagnostic challenges, therapeutic considerations, and importance of early recognition of these potentially severe neurological adverse events.