Conservative management of nivolumab-induced pericardial effusion: a case report and review of literature

Experimental Hematology & Oncology
Shagufta ShaheenChung-Tsen Hsueh

Abstract

Nivolumab is an immune checkpoint inhibitor targeting programmed death-1 protein and has been approved for the treatment of multiple advanced malignancies. Adverse effects of immune checkpoint inhibitors are distinct from conventional cytotoxic chemotherapy and can be life-threatening if left unrecognized. Here, we present a case of nivolumab-induced pericardial effusion successfully managed with high-dose corticosteroids. A 70-year-old Caucasian female with a history of 50-pack-year cigarette smoking was diagnosed of recurrent adenocarcinoma of lung after initial surgery. She progressed through multiple lines of chemotherapy and was eventually started on nivolumab. She developed a large pericardial effusion, grade 3 by Common Terminology Criteria for Adverse Events v4.0, about 4 days after receiving first nivolumab treatment. She was treated with oral prednisone at 1 mg/kg daily with gradual resolution of pericardial effusion over 5 weeks while she still received nivolumab every 2 weeks. Prednisone treatment was eventually tapered off about 10 weeks from initial nivolumab treatment. However 1 week after stopping prednisone, she again presented with shortness of breath and bilateral ankle edema, imaging confirmed recurrent peri...Continue Reading

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Citations

Apr 17, 2019·Special Care in Dentistry : Official Publication of the American Association of Hospital Dentists, the Academy of Dentistry for the Handicapped, and the American Society for Geriatric Dentistry·Mohamed Ahmed Abdel-KaderMostafa Ibrahim Mostafa
May 28, 2019·Minerva medica·Giacomo CorradoGabriella Ferrandina
Oct 20, 2019·Journal for Immunotherapy of Cancer·Anastasia SaadeLaurence Weiss
Mar 5, 2020·Asia-Pacific Journal of Clinical Oncology·Yingxian Liu, Wei Wu
Feb 5, 2019·Cardiovascular Research·Jiun-Ruey HuJavid Moslehi
Oct 3, 2020·International Journal of Molecular Sciences·Grzegorz SławińskiEwa Lewicka
Dec 26, 2018·Clinical and Experimental Immunology·A PawłowskaI Wertel
Jan 9, 2021·Current Oncology Reports·Flora PirozziValentina Mercurio
Apr 21, 2021·Cancer Immunology, Immunotherapy : CII·Alessandro InnoStefania Gori
Jul 19, 2021·The American Journal of Emergency Medicine·Demis N LipePatrick Chaftari

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Methods Mentioned

BETA
biopsy
hormone replacement

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