Aseptic meningitis induced by monoclonal antibodies used in cancer treatment: a systematic review

Background and purpose: Monoclonal antibodies (MAbs) have revolutionized cancer treatment but are associated with a spectrum of adverse events, including neurological complications. Understanding the mechanism and management of complications is crucial for optimizing patient care. The present systematic review aimed to identify case reports of MAbs used for cancer treatment that resulted in aseptic meningitis (AM). Methods: Databases including Google Scholar, PubMed, and Scopus were searched for studies published until March 2024 (updated in May 2025). The Joanna Briggs Institute (JBI) critical appraisal checklist was used to assess the quality of case report studies, and the methodological quality of the included studies was considered acceptable. Findings/Results: In total, 32 articles were analyzed in the present systematic review. Cetuximab had the highest reported incidence of AM, while rituximab, daratumumab, and apolizumab had the lowest prevalence. The quality of the studies was also acceptable. Conclusion and implications: AM appears to occur more frequently with monoclonal antibodies than with conventional drug structures. Prompt recognition of the underlying mechanisms can help physicians manage these complications more effectively.