Myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD) following atezolizumab and bevacizumab treatment for hepatocellular carcinoma.

[OBJECTIVE] To present a case of myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD) following atezolizumab and bevacizumab therapy and systematically review the literature on immune checkpoint inhibitor (ICI)-associated antibody-mediated central nervous system (CNS) inflammatory demyelinating diseases.

[BACKGROUND] While ICIs have transformed cancer treatment, they can trigger diverse neurological immune-related adverse events. Autoimmune demyelinating disorders remain uncommon, with sparse published cases linking ICIs to MOGAD. We report a novel case of MOGAD developing after administration of atezolizumab plus bevacizumab.

[METHOD] We conducted a retrospective chart review of the index case and performed a systematic literature review (January 1, 2001, to April 30, 2025) of reported antibody-mediated CNS demyelinating disorders associated with ICIs.

[RESULT] This represents the first documented MOGAD case during atezolizumab and bevacizumab treatment for hepatocellular carcinoma. The patient achieved a favorable response to intravenous methylprednisolone and immunoglobulin therapy. Further research is warranted to elucidate the pathogenesis underlying ICI-associated MOGAD.