Advanced Practice

Neurologic Complications: Effects of Ipilimumab and Nivolumab Therapy in Patients With Metastatic Melanoma

Jessica Latchman

Ann Guastella

Cindy S. Tofthagen

melanoma, immunotherapy, side effects, management, neurologic complications
CJON 2019, 23(4), 355-358. DOI: 10.1188/19.CJON.355-358

Checkpoint inhibitors are a form of immunotherapy that have revolutionized treatment for malignant melanoma, resulting in longer survival and better disease control. Multiple autoimmune disorders can occur with the use of checkpoint inhibitors, including severe, potentially fatal neurologic complications. Although neurologic complications are uncommon, their early recognition and treatment is required. The purpose of this article is to present information on neurologic complications of ipilimumab and nivolumab to inform nursing practice. Recommendations for evaluation and treatment of neurologic complications are reviewed.


  • Immunotherapy has resulted in significantly improved survival rates for melanoma. However, it has caused immune-related neurologic complications.
  • The combination of ipilimumab and nivolumab increases the risk of neurologic complications compared to single-drug therapy.
  • Prompt recognition and treatment of neurologic complications can decrease mortality. 
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