In a patient with extensive stage small cell lung cancer and a neurologic paraneoplastic syndrome do you feel comfortable using an ICI along with the chemotherapy?  

I have not used immune checkpoint inhibitors (ICI's) in patients with SCLC that have neurological paraneoplastic syndromes. These syndromes can be quite debilitating and given the risk of exacerbation of the symptoms by ICI use, I have not used them in this setting. One has to remember that the use ...