Evaluation of warning strategies for paraneoplastic neurological syndromes associated with PD-1/PD-L1 inhibitors

Among patients with PD-1/PD-L1 inhibitor-related PNS, those with risk-antibody positivity had worse prognoses, while patients with unknown-risk antibodies had outcomes similar to those with antibody negativity, suggesting that unknown-risk antibodies are not directly pathogenic or may elicit weaker immune responses. Pre-treatment screening for PNS-related antibodies is recommended, as it may facilitate early warning, identify high-risk patients, and help prevent autoimmune-related diseases caused by excessive immune modulation. After disease onset, efficient immunomodulatory treatment tailored to antibody subtypes may improve outcomes in risk-antibody-positive patients.