Renal Failure Management in Patients with Metastatic Renal Cancer Receiving Nivolumab: Evaluation from Two Points of View
Arch. esp. urol. (Ed. impr.)
; 75(9): 798-802, 28 nov. 2022. ilus
Article
in English
| IBECS
| ID: ibc-212774
Responsible library:
ES1.1
Localization: ES15.1 - BNCS
ABSTRACT
Introduction:
Immunotherapy is recommended as category 1 in first-line treatment in metastatic renal cancer (mRC), however the evidence on the management of toxicities in patients with chronic renal failure is limited. Description of the Cases Case 1 Patient with mRC and renal failure on hemodialysis. After 25 months of treatment with Nivolumab, he presented a partial response, without toxicities. Case 2 Patient with mRC undergoing treatment with Nivolumab-Ipilimumab, who after 6 cycles was admitted for acute renal failure, compatible with grade 4 nephrotoxicity, requiring definitive suspension of treatment, corticosteroid therapy and hemodialysis.Conclusions:
Nivolumab is a safe and effective therapy in hemodialysis patients, not increasing adverse events, nor requiring dose adjustment. Immunotherapy nephrotoxicity must be adequately managed in daily clinical practice in an interdisciplinary way with the nephrologist (AU)RESUMEN
Introducción:
La inmunoterapia está recomendadacon categoría 1 en primera línea de tratamiento en cáncerrenal metastásico (CRm), sin embargo la evidencia sobre elmanejo de toxicidades en pacientes con insuficiencia renalcrónica es limitada.Descripción de los Casos Caso 1 Paciente con CRme insuficiencia renal en hemodiálisis. Tras 25 meses detratamiento con Nivolumab, presenta respuesta parcial, sintoxicidades. Caso 2 Paciente con CRm en tratamiento conNivolumab-Ipilimumab, que tras 6 ciclos precisa ingresopor fracaso renal agudo, compatible con nefrotoxicidadgrado 4, requiriendo suspensión definitiva del tratamiento,corticoterapia y hemodiálisis.Conclusiones:
El uso de Nivolumab es seguro y eficaz en pacientes en hemodiálisis, no incrementando losefectos adversos, ni precisando ajuste de dosis. Es fundamental conocer el manejo de la nefrotoxicidad por inmunoterapia en la práctica clínica diaria y establecer un enfoque multidisciplinar con nefrología. (AU)
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Collection:
National databases
/
Spain
Database:
IBECS
Main subject:
Carcinoma, Renal Cell
/
Renal Insufficiency
/
Ipilimumab
/
Antineoplastic Agents, Immunological
/
Nivolumab
/
Kidney Neoplasms
Limits:
Female
/
Humans
/
Male
Language:
English
Journal:
Arch. esp. urol. (Ed. impr.)
Year:
2022
Document type:
Article
Institution/Affiliation country:
Hospital Universitario Puerta del Mar/España