Shailee S. Shah, MD, is a clinical assistant professor of Neurology (MS/Neuroimmunology) at Northwestern University Feinberg School of Medicine. 

Jacob Sands, MD, is associate chief of the Lowe Center for Thoracic Oncology and oncology medical director of the International Patient Center at Dana-Farber Cancer Institute; as well as an assistant professor at Harvard Medical School

, which provides oncology professionals with the resources and information they need to provide the best patient care. In both digital and print formats, 

 covers every angle of oncology practice, from new technology to treatment advances to important regulatory decisions.

In today’s episode, we had the pleasure of speaking with Jacob Sands, MD, and Shailee Shah, MD, about considerations for diagnosing and managing Lambert-Eaton myasthenic syndrome (LEMS), particularly in the context of small cell lung cancer (SCLC). Dr Sands is associate chief of the Lowe Center for Thoracic Oncology and the Oncology Medical Director of the International Patient Center at Dana-Farber Cancer Institute, as well as an assistant professor at Harvard Medical School in Boston, Massachusetts. Dr Shah is a clinical assistant professor of neurology (MS/neuroimmunology) at the Northwestern University Feinberg School of Medicine in Chicago, Illinois. 

In our exclusive interview, Drs Sands and Shah discussed LEMS symptom identification, the importance of paraneoplastic panels for assessing neurologic dysfunction in patients with SCLC, the need for specific autoantibody testing, and what guidelines currently note as best practices for the diagnosis of this disease. 

That’s all we have for today! Thank you for listening to this episode of 

. Check back throughout the week for exclusive interviews with leading experts in the oncology field.

For more updates in oncology, be sure to visit www.OncLive.com and sign up for our e-newsletters.

 is also on social media. On X and BlueSky, follow us at @OncLive. On Facebook, like us at OncLive, and follow our OncLive page on LinkedIn.

, please consider subscribing to our podcast on Apple Podcasts, Spotify, and many of your other favorite podcast platforms,* so you get a notification every time a new episode is posted. While you are there, please take a moment to rate us!

is available on: Apple Podcasts, Spotify, CastBox, Podcast Addict, Podchaser, RadioPublic, and TuneIn.

episode is supported by funding, however, content is produced and independently developed by

Podcasts

Drs Sands and Shah discuss LEMS symptom identification and what guidelines currently note as best practices for the diagnosis of this disease. 

Accurate Symptom Identification and Guidelines Support LEMS Screening and Diagnosis: With Jacob Sands, MD; and Shailee Shah, MD

, which provides oncology professionals with the resources and information they need to provide the best patient care. In both digital and print formats, OncLive covers every angle of oncology practice, from new technology to treatment advances to important regulatory decisions.

In today’s OncClub episode, we had the pleasure of speaking with Shailee S. Shah, MD, about a retrospective study she and colleagues conducted to understand the effect of immune checkpoint inhibitors on patients with cancer and pre-existing neurologic autoimmune diseases, including multiple sclerosis, myasthenia gravis, Guillain-Barre syndrome, and Parkinson's disease. Dr Shah is a clinical assistant professor of neurology (MS/neuroimmunology) at the Northwestern University Feinberg School of Medicine in Chicago, Illinois. 

In our exclusive interview, Dr Shah discussed the design of this study, key findings, and how these results emphasize the need for multidisciplinary care and risk stratification for more effective and comprehensive patient care. 

 to see additional findings and insights from this research!
___

That’s all we have for today! Thank you for listening to

. Check back on Mondays and Thursdays for exclusive interviews with leading experts in the oncology field.

OncLive On Air is available on: Apple Podcasts, Spotify, CastBox, Podcast Addict, Podchaser, RadioPublic, and TuneIn.

Dr Shah discusses a study of the effect of immune checkpoint inhibitors on patients with cancer and preexisting neurologic autoimmune diseases.

Efficacy of Immune Checkpoint Inhibition in Oncology May Translate to Neurologic Disorders: With Shailee S. Shah, MD

Dr Shah on Disease-Related Exacerbation With ICIs in Patients With Cancer and Preexisting NAIDs

"Although ICIs can be used safely [in this patient population], we still don't yet know [for] whom that is going to be the case. The likelihood of a relapse or severe worsening is relatively high [for patients with myasthenia gravis]. We have to be very careful when considering ICIs for these patients."

Shailee S. Shah, MD, a clinical assistant professor of Neurology (MS/Neuroimmunology) at Northwestern University Feinberg School of Medicine, shared findings from a retrospective cohort study assessing the exacerbation of pre-existing neurologic autoimmune disorders (NAIDs) in patients with cancer receiving immune checkpoint inhibitors (ICIs), as well as clinical outcomes with this therapy across conditions. 

The study included 135 patients with multiple sclerosis (n = 45), myasthenia gravis (n = 18), Guillain-Barré syndrome (n = 10), and Parkinson’s disease (n = 57), which served as the control cohort.

, and showed that NAID exacerbations were most frequently observed in patients with myasthenia gravis, with 67% experiencing a relapse, Shah reported. Among these patients, 50% required hospitalization and 17% died, indicating a high risk of severe adverse effects. In contrast, the exacerbation rate in patients with multiple sclerosis was 18%, and there were no significant differences in cancer response rate, progression-free survival, or overall survival across the NAID subgroups.

Although patients with myasthenia gravis receiving active immunosuppressive therapy appeared less likely to experience exacerbations, the sample size was insufficient to determine statistical significance, Shah explained. Among those with exacerbations, half required hospitalization and immunosuppressive treatment, and 56% subsequently discontinued ICI therapy, she said. One patient who was rechallenged with an ICI after initiating immunosuppressive therapy tolerated it well, Shah noted. However, 2 patients died due to complications related to worsening myasthenia gravis.

These findings highlight the importance of careful risk–benefit assessment when considering ICIs for patients with pre-existing NAIDs, particularly myasthenia gravis, Shah asserted. Although durable oncologic responses were observed in many patients who continued ICI therapy, the potential for severe neurologic exacerbation must be weighed when determining treatment appropriateness in this high-risk subgroup, she concluded.

Videos

Shailee S. Shah, MD, shares data on the frequency and severity of NAID exacerbation with ICIs in patients with cancer.

Shailee S. Shah, MD

Articles

Accurate Symptom Identification and Guidelines Support LEMS Screening and Diagnosis: With Jacob Sands, MD; and Shailee Shah, MD

Efficacy of Immune Checkpoint Inhibition in Oncology May Translate to Neurologic Disorders: With Shailee S. Shah, MD

Dr Shah on Outcomes With Checkpoint Inhibition in Patients With Cancer and Pre-Existing Neurologic Autoimmune Disorders