Efficacy of Nivolumab in a Patient with Metastatic Renal Cell Carcinoma and End-Stage Renal Disease on Dialysis: Case Report and Literature Review
Treatment of patients with metastatic renal cell carcinoma (mRCC) and end-stage renal disease (ESRD) on dialysis poses a therapeutic challenge, particularly as this patient group was excluded from the pivotal clinical trials. In addition, there is uncertainty regarding drug dosing/pharmacokinetics,...
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| Format: | Article |
| Language: | English |
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Wiley
2018-01-01
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| Series: | Case Reports in Immunology |
| Online Access: | http://dx.doi.org/10.1155/2018/1623957 |
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| _version_ | 1832564403027836928 |
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| author | Jawaher Ansari Muhammad Ali Ashraf Farrag Arwa M. Ali Abdulaziz Alhamad |
| author_facet | Jawaher Ansari Muhammad Ali Ashraf Farrag Arwa M. Ali Abdulaziz Alhamad |
| author_sort | Jawaher Ansari |
| collection | DOAJ |
| description | Treatment of patients with metastatic renal cell carcinoma (mRCC) and end-stage renal disease (ESRD) on dialysis poses a therapeutic challenge, particularly as this patient group was excluded from the pivotal clinical trials. In addition, there is uncertainty regarding drug dosing/pharmacokinetics, lack of safety and efficacy data, and potential for increased toxicity when using targeted therapy or immunotherapy for the management of patients with mRCC on dialysis. Nivolumab, an anti-programmed death-1 immune checkpoint inhibitor antibody, is indicated for the treatment of patients with mRCC who have received prior antiangiogenic therapy. Given the above-mentioned uncertainties, clinicians may be reluctant to use nivolumab for this patient population, leading to potential denial of life-prolonging medications. We report the case of a 72-year-old gentleman with mRCC and ESRD on dialysis who received second-line nivolumab therapy and achieved an excellent symptomatic and radiological response, remaining progression-free for over 22 months. In addition, we have reviewed the pharmacokinetic data and published retrospective case studies to review the management options for patients with mRCC and ESRD on dialysis. |
| format | Article |
| id | doaj-art-58b51453788244a585a8b5a46898bed7 |
| institution | Kabale University |
| issn | 2090-6609 2090-6617 |
| language | English |
| publishDate | 2018-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Immunology |
| spelling | doaj-art-58b51453788244a585a8b5a46898bed72025-02-03T01:11:02ZengWileyCase Reports in Immunology2090-66092090-66172018-01-01201810.1155/2018/16239571623957Efficacy of Nivolumab in a Patient with Metastatic Renal Cell Carcinoma and End-Stage Renal Disease on Dialysis: Case Report and Literature ReviewJawaher Ansari0Muhammad Ali1Ashraf Farrag2Arwa M. Ali3Abdulaziz Alhamad4Department of Oncology, Prince Sultan Military Medical City, Riyadh, Saudi ArabiaDepartment of Oncology, Prince Sultan Military Medical City, Riyadh, Saudi ArabiaClinical Oncology Department, Assiut University, Asyut, EgyptMedical Oncology Department, South Egypt Cancer Institute, Asyut, EgyptDepartment of Oncology, Prince Sultan Military Medical City, Riyadh, Saudi ArabiaTreatment of patients with metastatic renal cell carcinoma (mRCC) and end-stage renal disease (ESRD) on dialysis poses a therapeutic challenge, particularly as this patient group was excluded from the pivotal clinical trials. In addition, there is uncertainty regarding drug dosing/pharmacokinetics, lack of safety and efficacy data, and potential for increased toxicity when using targeted therapy or immunotherapy for the management of patients with mRCC on dialysis. Nivolumab, an anti-programmed death-1 immune checkpoint inhibitor antibody, is indicated for the treatment of patients with mRCC who have received prior antiangiogenic therapy. Given the above-mentioned uncertainties, clinicians may be reluctant to use nivolumab for this patient population, leading to potential denial of life-prolonging medications. We report the case of a 72-year-old gentleman with mRCC and ESRD on dialysis who received second-line nivolumab therapy and achieved an excellent symptomatic and radiological response, remaining progression-free for over 22 months. In addition, we have reviewed the pharmacokinetic data and published retrospective case studies to review the management options for patients with mRCC and ESRD on dialysis.http://dx.doi.org/10.1155/2018/1623957 |
| spellingShingle | Jawaher Ansari Muhammad Ali Ashraf Farrag Arwa M. Ali Abdulaziz Alhamad Efficacy of Nivolumab in a Patient with Metastatic Renal Cell Carcinoma and End-Stage Renal Disease on Dialysis: Case Report and Literature Review Case Reports in Immunology |
| title | Efficacy of Nivolumab in a Patient with Metastatic Renal Cell Carcinoma and End-Stage Renal Disease on Dialysis: Case Report and Literature Review |
| title_full | Efficacy of Nivolumab in a Patient with Metastatic Renal Cell Carcinoma and End-Stage Renal Disease on Dialysis: Case Report and Literature Review |
| title_fullStr | Efficacy of Nivolumab in a Patient with Metastatic Renal Cell Carcinoma and End-Stage Renal Disease on Dialysis: Case Report and Literature Review |
| title_full_unstemmed | Efficacy of Nivolumab in a Patient with Metastatic Renal Cell Carcinoma and End-Stage Renal Disease on Dialysis: Case Report and Literature Review |
| title_short | Efficacy of Nivolumab in a Patient with Metastatic Renal Cell Carcinoma and End-Stage Renal Disease on Dialysis: Case Report and Literature Review |
| title_sort | efficacy of nivolumab in a patient with metastatic renal cell carcinoma and end stage renal disease on dialysis case report and literature review |
| url | http://dx.doi.org/10.1155/2018/1623957 |
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