Successful treatment of metastatic clear cell carcinoma with nivolumab in a patient receiving dialysis treatment

Abstract

The efficacy and safety of nivolumab for patients receiving dialysis treatment has not been established yet. Herein, we describe a patient on dialysis successfully treated with nivolumab as seventh-line therapy for metastatic renal cell carcinoma. Before initiating nivolumab, he had respiratory discomfort induced by a lesion occluding the left intermediate bronchus that originated from the metastatic lymph node behind the tracheal bifurcation. Four weeks after nivolumab was initiated, his symptom remarkably improved, and the occlusion disappeared according to the bronchoscopy examination. The effectiveness and safety of nivolumab has continued for 6 months. There are few cases in which nivolumab has been given to patients on dialysis. In the present case, nivolumab was given to a patient on dialysis, and it resulted in a remarkable improvement without any adverse events.

Outcomes and Safety of Biweekly and Monthly Nivolumab in Patients with Metastatic Renal Cell Carcinoma and Dialysis: Three Case Reports and Literature Review

“…Current evidence about the efficacy and safety of nivolumab in met-astatic RCC patients on dialysis is very scarce, limited to three case reports ( Table 1). None of them suffered significant toxicities (grade 2-4), and two patients showed clinical benefit [6][7][8].…”

Rapidly progressing programmed cell death 1 inhibitor‐related pneumonitis in a hemodialytic patient with metastatic renal cell carcinoma

“…HD patients were excluded from the prospective clinical trials such as Checkmate 025 and Checkmate 057 . To our knowledge, only a few reports on the safety and efficacy of PD‐1 inhibitors in HD patients were have been published. Tabei et al .…”

“…To our knowledge, only a few reports on the safety and efficacy of PD‐1 inhibitors in HD patients were have been published. Tabei et al . reported that in an HD patient with metastatic RCC nivolumab led to marked improvement without adverse effects in 4 weeks.…”

Use of Immune Checkpoint Inhibitors in End Stage Kidney Disease Patients, Single Center Experience and Review of the Literature

“…A total of 26 patients have previously been described in the literature (5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18), with the majority of them from two centers,(2,3) and mostly receiving HD (92%). A variety of malignancies were treated (melanoma 35%, and renal cell carcinoma 54%, with the remainder composed of squamous cell skin cancer, urothelial cancer, and non-small cell lung cancer).…”