Safe use of nivolumab in a patient with renal cell carcinoma and hepatitis B

J Oncol Pharm Pract. 2020 Jun;26(4):1022-1024. doi: 10.1177/1078155219882071. Epub 2019 Oct 21.

Abstract

Introduction: Immunotherapy with checkpoint inhibitors gains a major role in bladder cancer. Because of the treatment's immune modulatory effects, patients may develop hepatitis. Hepatitis B was an exclusion criterion in clinical trials that investigated nivolumab. Therefore, its effects and risk of hepatitis B reactivation in nivolumab are not clinically investigated in renal cell carcinoma patients with hepatitis B.

Case report: In this case report, we presented a metastatic renal cell carcinoma patient who was treated with anti-viral treatment for hepatitis reactivation caused by previous sunitinib therapy. After progression, nivolumab was commenced and the patient was closely monitored with hepatic function tests.

Management and outcome: Nivolumab was well tolerated and no treatment-related adverse effect occurred. Hepatitis or viral hepatitis reactivation was not detected.

Discussion: This case supports the safety of nivolumab in patients with renal cell carcinoma and viral hepatitis.

Keywords: Hepatitis B; hepatitis reactivation; nivolumab; renal cell carcinoma.

Publication types

  • Case Reports

MeSH terms

  • Antineoplastic Agents, Immunological / therapeutic use*
  • Carcinoma, Renal Cell / complications
  • Carcinoma, Renal Cell / diagnostic imaging
  • Carcinoma, Renal Cell / drug therapy*
  • Hepatitis B / complications
  • Hepatitis B / diagnostic imaging
  • Hepatitis B / drug therapy*
  • Humans
  • Immunotherapy / methods
  • Kidney Neoplasms / complications
  • Kidney Neoplasms / diagnostic imaging
  • Kidney Neoplasms / drug therapy*
  • Male
  • Middle Aged
  • Nivolumab / therapeutic use*

Substances

  • Antineoplastic Agents, Immunological
  • Nivolumab