Lambert-Eaton Myasthenic Syndrome Caused by Atezolizumab in a Patient with Small-cell Lung Cancer

Eiji Kunii; Sota Owaki; Kazuki Yamada; Misuzu Yoshihara; Yusuke Yamaba; Osamu Takakuwa; Takanari Toyoda; Kenji Akita

doi:10.2169/internalmedicine.8387-21

This article has now been updated. Please use the final version.

Lambert-Eaton Myasthenic Syndrome Caused by Atezolizumab in a Patient with Small-cell Lung Cancer

Eiji Kunii, Sota Owaki, Kazuki Yamada, Misuzu Yoshihara, Yusuke Yamaba, Osamu Takakuwa, Takanari Toyoda, Kenji Akita

Author information

Eiji Kunii
Department of Respiratory Medicine, Thoracic Oncology Center, Nagoya City University West Medical Center, Japan
Sota Owaki
Department of Respiratory Medicine, Thoracic Oncology Center, Nagoya City University West Medical Center, Japan
Kazuki Yamada
Department of Respiratory Medicine, Thoracic Oncology Center, Nagoya City University West Medical Center, Japan
Misuzu Yoshihara
Department of Respiratory Medicine, Thoracic Oncology Center, Nagoya City University West Medical Center, Japan
Yusuke Yamaba
Department of Respiratory Medicine, Thoracic Oncology Center, Nagoya City University West Medical Center, Japan
Osamu Takakuwa
Department of Respiratory Medicine, Thoracic Oncology Center, Nagoya City University West Medical Center, Japan
Takanari Toyoda
Department of Neurology, Nagoya City University West Medical Center, Japan
Kenji Akita
Department of Respiratory Medicine, Thoracic Oncology Center, Nagoya City University West Medical Center, Japan

Keywords: Lambert-Eaton myasthenic syndrome, Small-cell lung cancer, Atezolizumab, Immune checkpoint inhibitor, Immune-related adverse events

JOURNAL OPEN ACCESS Advance online publication

Article ID: 8387-21

DOI https://doi.org/10.2169/internalmedicine.8387-21

The final version of this article is now available: Vol. 61 (2022), No. 11 pp. 1739-1742

Details

Abstract

We herein report a 74-year-old man who developed Lambert-Eaton myasthenic syndrome (LEMS) during atezolizumab treatment for extensive-stage small-cell lung cancer. He was started on maintenance immunotherapy with atezolizumab every three weeks after four cycles of atezolizumab plus carboplatin plus etoposide combination therapy. After 13 cycles of maintenance atezolizumab therapy, he complained of muscular weakness and fatigue. Findings from a nerve conduction study and positive findings for anti-P/Q-type voltage-gated calcium channel antibody resulted in a diagnosis of LEMS. This was a rare case of LEMS as a neurological immune-related adverse event induced by atezolizumab therapy.

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