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Medicine Grand Rounds - Neuro-Axis on Fire:  Checkpoint Inhibitor Neuritis / Encephalitis and CAR-T Neurotoxicity. How fast can it burn?

Dr. Chan describes the clinical syndromes and neurologic presentations of complications of checkpoint inhibitor and CAR-T therapies. She summarizes diagnostic criteria, grading systems and current pathophysiologic understanding for symptoms of encephalitis, myasthenia gravis, Guillaume-Barre Syndrome and immune effector cell-associated neurotoxicity syndrome related to CAR-T, as well as consensus management guidelines and prognosis.

Activity Details

Start Date:  December 18, 2020
End Date:  December 18,2023

You may claim CME credit for successful completion of this online course. In order to claim credit, you must follow these steps:

  1. Register for the learning activity by creating an account or logging in to your account.
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  3. Return to this Activity page.
  4. Click Continue to navigate to the Evaluation tab; then click the Launch button to start the evaluation.
  5. Complete and Submit the evaluation and attestation form.

When the evaluation is submitted, you will be awarded credit. You may access your transcript for verification of participation at any time via Your Account. Need help? Visit the Support Page, send an Email, or call the Center for Learning and Professional Development at (603) 653-1234, Option 1.

Learning Outcome

Participants will be able to describe the diagnosis, grading system and management of complications of checkpoint inhibitor and CAR-T therapies.

  • Amy M. Chan, MD
    Assistant Professor of Medicine
    Geisel School of Medicine at Dartmouth
    Section of Medical Oncology
    Dartmouth-Hitchcock Medical Center

    About our presenter: 
    Dr. Chan earned a BS in Engineering from Duke University and an MS in Engineering from Stanford University.  She received her MD with honors from Geisel School of Medicine at Dartmouth and completed her training in Neurology and fellowship in Neuro-Oncology at Yale-New Haven Hospital.  She is a certified adult Neuro-Oncologist, specializing in the treatment of adult patients with glioblastoma, CNS lymphoma, rare nervous system tumors including malignant peripheral nerve sheath tumor, and neurologic complications of systemic cancer and its treatment.  She is a clinician at heart and continues to work on bedside evaluation of clinical neurologic manifestations to gain new insights into the effects of emerging therapeutics.

Dartmouth-Hitchcock is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

Dartmouth-Hitchcock designates this enduring material for a maximum of 1 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Requirements for Successful Completion

In order to receive credit for this Continuing Medical Education (CME) activity, you must:

  • View the entire presentation
  • Complete the online Attestation of Attendance & Evaluation Form (you must register to access).

In accordance with the disclosure policy of Dartmouth-Hitchcock/Geisel School of Medicine at Dartmouth as well as standards set forth by the Accreditation Council on Continuing Medical Education and the Nursing Continuing Education Council standards set forth by the American Nurses Credentialing Center Commission on Accreditation, continuing medical education and nursing education activity director(s), planning committee member(s), speaker(s), author(s) or anyone in a position to control the content have been asked to disclose any financial relationship* they have to a commercial interest (any entity producing, marketing, re-selling, or distributing health care goods or services consumed by, or used on patients). Such disclosure is not intended to suggest or condone bias in any presentation, but is elicited to provide participants with information that might be of potential importance to their evaluation of a given activity.

The following Activity Physician Director(s), planning committee member(s), speaker(s), author(s) or anyone in a position to control the content have reported the following financial interest or relationship* with various companies/organizations. The Activity Director and Planning Committee member roles were resolved by altering the individual’s control over content about the products or services of the commercial interest by the Associate Dean for CME and the Department of Medicine Chair. All potential conflict(s) were resolved.

* Kelly Kieffer, MD ~ her spouse is a consultant for OcculoBio. 

* Richard I. Rothstein, MD ~ has research support from Baranova (research grant to Dartmouth-Hitchcock Medical Center) and is on the Scientific Advisory Board for Allurion.

Other planning committee member(s), speaker(s), activity director(s), author(s) or anyone in a position to control the content for this program report no financial interest or relationship* with any company(ies) or organizations whose product may be germane to the content of their presentations.

*A “financial interest or relationship" refers to an equity position, receipt of royalties, consultantship, funding by a research grant, receiving honoraria for educational services elsewhere, or to any other relationship to a company that provides sufficient reason for disclosure, in keeping with the spirit of the stated policy.

Bibliographic References
  • See presentation for bibliographic sources to allow for further study.

Provider Contact Information

Provider contact information for questions regarding accreditation of the activity:

Center for Learning and Professional Development
Dartmouth-Hitchcock Medical Center

Type:     Internet Activity (Enduring Material)
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