About Cancer-Associated LEMS
Cancer-Associated Lambert-Eaton myasthenic syndrome (CA-LEMS) is the most common antibody-mediated neurologic paraneoplastic syndrome in SCLC1
LEMS associated with cancer is a progressive, debilitating, and treatable neuromuscular disorder.3,6
Symptoms of Cancer-Associated LEMS are caused by the production of anti-voltage-gated calcium channel (VGCC) antibodies that impair signal transmission at the neuromuscular junction3,7
It is speculated anti-VGCC antibodies, as well as other soluble components in patients with Cancer-Associated LEMS, may inhibit SCLC tumor cell proliferation8
- Clinical data suggest that the immune response associated with LEMS may suppress tumor activity, thus prolonging survival times of LEMS patients with cancer9,10
- LEMS diagnosis can be confirmed with a VGCC-Ab test, both P/Q and N types—a simple, readily available, inexpensive blood test3,11
- Testing for LEMS is important: The weakness associated with LEMS in patients with Cancer-Associated LEMS is treatable3,12,13
Patients with Cancer-Associated LEMS frequently have an underlying SCLC diagnosis14
Discover the Signs of Cancer-Associated LEMS
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References:
- Gandhi L, Johnson BE. Paraneoplastic syndromes associated with small cell lung cancer. J Natl Compr Canc Netw. 2006;4(6):631-638.
- Titulaer MJ, Lang B, Verschuuren JJ. Lambert-Eaton myasthenic syndrome: from clinical characteristics to therapeutic strategies. Lancet Neurol. 2011;10(12):1098-1107.
- Gilhus NE. Lambert-Eaton myasthenic syndrome; pathogenesis, diagnosis, and therapy. Autoimmune Dis. 2011;2011:973808.
- Bebb DG, Murray C, Giannopoulou A, Felip E. Symptoms and experiences with small cell lung cancer: a mixed methods study of patients and caregivers. Pulm Ther. 2023;9:435-450.
- Yoon CH, Owusu-Guha J, Smith A, Buschur P. Amifampridine for the management of Lambert-Eaton myasthenic syndrome: a new take on an old drug. Ann Pharmacother. 2020;54(1):56-63.
- Wirtz PW, Smallegange TM, Wintzen AR, Verschuuren JJ. Differences in clinical features between the Lambert-Eaton myasthenic syndrome with and without cancer: an analysis of 227 published cases. Clin Neurol Neurosurg. 2002;104(4):359-363.
- Hartmann GG, Sage J. Small-cell lung cancer neuronal features and their implications for tumor progression, metastases, and therapy. Mol Cancer Res. 2024;22(9):787-795.
- Maddison P, Gozzard P, Grainge MJ, Lang B. Long-term survival in paraneoplastic Lambert-Eaton myasthenic syndrome. Neurology. 2017;88:1-6.
- Titulaer MJ, Verschuuren JJ. Lambert-Eaton myasthenic syndrome: tumor versus nontumor forms. Ann N Y Acad Sci. 2008;1132:129-34.
- Lipka AF, Boldingh MI, van Zwet EW, et al. Long-term follow-up, quality of life, and survival of patients with Lambert-Eaton myasthenic syndrome. Neurology. 2020;94(5):e511-e520.
- ARUP Laboratories. Accessed August 2, 2025. https://ltd.aruplab.com/Tests/Pub/3002046
- Referenced with permission from the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) for Small Cell Lung Cancer V.1.2026. © National Comprehensive Cancer Network, Inc. 2025. All rights reserved. Accessed August 8, 2025. To view the most recent and complete version of the guideline, go online to NCCN.org. NCCN makes no warranties of any kind whatsoever regarding their content, use or application and disclaims any responsibility for their application or use in any way.
- Kunii E, Owaki S, Yamada K, et al. Lambert-Eaton myasthenic syndrome caused by atezolizumab in a patient with small-cell lung cancer. Intern Med. 2022;61:1739-1742.
- Giannoccaro MP, Avoni P, Liguori R. Presynaptic paraneoplastic disorders of the neuromuscular junction: an update. Brain Sci. 2021;11(8):1035.
- Titulaer MJ, Lang B, Verschuuren JJ. Lambert-Eaton myasthenic syndrome: from clinical characteristics to therapeutic strategies. Lancet Neurol. 2011; Appendix:1-4.
- Harms L, Sieb JP, Williams AE, et al. Long-term disease history, clinical symptoms, health status, and healthcare utilization in patients suffering from Lambert Eaton myasthenic syndrome: results of a patient interview survey in Germany. J Med Econ. 2012;15(3):521-530.
- Morrell D, Drapkin B, Shechter G, Grebla R. Lambert-Eaton myasthenic syndrome is underrecognized in small cell lung cancer: an analysis of real-world data. Presented as a poster at the International Association for the Study of Lung Cancer (IASLC) – WCLC Annual Meeting 2023. September 9-12, 2023, Singapore.
- Sanders DB. Lambert-Eaton myasthenic syndrome: diagnosis and treatment. Ann N Y Acad Sci. 2003;998:500-508.
- Catterall WA. Voltage-gated calcium channels. Cold Spring Harb Perspect Biol. 2011;3:a003947.
- Schampel A, Kuerten S. Danger: High voltage—the role of voltage-gated calcium channels in central nervous system pathology. Cells. 2017;6(4):43.
- Loser V, Vicino A, Théaudin M. Autoantibodies in neuromuscular disorders: a review of their utility in clinical practice. Front Neurol. 2024;15:1495205.
- Alhammad RM, Alshamian Y, Alneseyan R, Al-Harbi TM, Ajhijab A, Alanazy MH. Clinical presentations, electrophysiologic features, and long-term follow-up in Lambert-Eaton myasthenic syndrome: a series of six patients. Front Neurol. 2024;15:1525155.
- Labcorp. Voltage-gated calcium channel antibody (VGCCA). Accessed August 16, 2025. https://www.labcorp.com/tests/140640/voltage-gated-calcium-channel-antibody-vgcca
- Kesner VG, Shin JO, Dimachkie MM, Barohn RJ. Lambert-Eaton myasthenic syndrome. Neurol Clin. 2018;36(2):379-394.
- Silva T. Understanding lambert-eaton myasthenic syndrome: pathophysiology, diagnosis, and treatment. J Neurol Neurorehab Res. 2024;9(1):1-2.
- Ivanovski T, Miralles F. Lambert-Eaton myasthenic syndrome: early diagnosis is key. Degener Neurol Neuromuscul Dis. 2019;13:27-37.
