Abstract
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.
References
Jan 20, 2011·BJU International·Debra JosephsSimon Chowdhury
Feb 26, 2014·Clinical Genitourinary Cancer·Aditya V ShettyNizar M Tannir
Sep 16, 2014·International Journal of Cancer. Journal International Du Cancer·Jacques FerlayFreddie Bray
Sep 26, 2015·The New England Journal of Medicine·Robert J MotzerUNKNOWN CheckMate 025 Investigators
Nov 7, 2015·Future Oncology·Annalisa GuidaRoberto Sabbatini
Feb 24, 2016·Clinical Genitourinary Cancer·Alessandro LeonettiSebastiano Buti
Jun 18, 2016·European Urology·Maria I Carlo, Darren R Feldman
Dec 27, 2016·CPT: Pharmacometrics & Systems Pharmacology·G BajajY Feng
Jul 25, 2017·International Journal of Urology : Official Journal of the Japanese Urological Association·Tadashi TabeiKazuki Kobayashi
Mar 22, 2018·The New England Journal of Medicine·Robert J MotzerUNKNOWN CheckMate 214 Investigators
Citations
Sep 15, 2019·Thoracic Cancer·Akio OsaAtsushi Kumanogoh
Apr 3, 2020·American Society of Clinical Oncology Educational Book·Matthew TenoldPrimo N Lara
Jun 3, 2020·The Journal of Clinical Investigation·Kaiyuan WangRu-Rong Ji
Oct 10, 2018·Investigational New Drugs·Hyeon CheunBhumsuk Keam
Sep 9, 2020·Journal of Immunotherapy·Jayanshu JainRohan Garje
Dec 18, 2020·Frontiers in Oncology·Ming-Chun KuoYu-Li Su
Jan 12, 2021·IJU Case Reports·Takuya IwakiHaruki Kume
Mar 17, 2021·Cancer Treatment and Research Communications·Leah K ShawPavlos Msaouel
Mar 27, 2021·Cancer Chemotherapy and Pharmacology·Łukasz MielczarekAnna M Czarnecka
Mar 30, 2021·Respirology Case Reports·Mihoko ImajiNobuyuki Yamamoto
Jun 12, 2020·Seminars in Oncology·Elodie KlajerAntoine Thiery-Vuillemin
Aug 4, 2019·Clinical Genitourinary Cancer·Maria Giuseppa VitaleRoberto Sabbatini
Sep 4, 2021·Clinical Kidney Journal·Abhijat KitchluRimda Wanchoo
Sep 24, 2019·Case Reports in Oncology·Ryota MorinagaHiroji Uemura
Jan 9, 2020·Urologia Internationalis·Ignacio Osmán-GarcíaRafael Antonio Medina-López