TAR included an NK1 receptor antagonist, a 5-HT3 receptor antagonist (or fixed netupitant/palonosetron combination), and dexamethasone. There was a trend toward a longer median time to T-DXd dose reduction in the TAR group (15.7 vs. 3.9 months; P = 0.183). These findings suggest that upfront TAR may help maintain the dosing of T-DXd in patients with HER2-positive or HER2-low ABC.
Prompt multidisciplinary management with high-dose intravenous methylprednisolone, plasmapheresis, and intravenous immunoglobulin led to a gradual and significant improvement in cognitive function and GCS, with no recurrence of encephalitis during follow-up. This case highlights the critical importance of maintaining a high index of suspicion for atezolizumab-induced CNS encephalitis, emphasizing the need for early diagnosis, comprehensive diagnostic evaluation, and aggressive immunosuppressive therapy to achieve favorable neurological outcomes in patients receiving immune checkpoint inhibitors.
B-cell chronic lymphocytic leukemia (B-CLL) was diagnosed, which in cats is much less frequent than T-CLL. There was a favorable response to alkylating therapy, and the cat survived for 19 months.