Nivolumab-induced hepatitis: A rare side effect of an immune check point inhibitor.
J Oncol Pharm Pract
; 26(2): 459-461, 2020 Mar.
Article
em En
| MEDLINE
| ID: mdl-30909794
ABSTRACT
Immune checkpoint inhibitors have ushered in a new era in cancer management. Nivolumab is a human immunoglobulin G4 (IgG4) monoclonal antibody that selectively inhibits programmed cell death-1 (PD-1) activity by binding to the PD-1 receptor. This inhibits suppression of the T-cell activity, which can in turn cause increased killing of cancer cells. This alteration in the activity of the T cells can cause them to lose their ability to identify host cells and leads to immune-related adverse effects (irAE). Nivolumab-induced hepatotoxicity is rare and accounts for 3-6% of all irAE. We present a case of nivolumab-induced hepatitis. A woman who was treated for recurrent renal cell carcinoma presented with hepatitis. Workup for other causes was negative and the hepatitis was attributed to the administration of nivolumab. She was started on oral steroids followed which she initially improved. However, she later presented with massive upper gastrointestinal bleeding secondary to gastroduodenal ulcers and subsequently developed acute tubular necrosis and passed from the complications. Immune checkpoint inhibitors have proven to be a promising approach in the management of a wide array of neoplasms by immunomodulation. As these agents are becoming standard of therapy in the management of cancers, a heightened vigilance in the diagnosis of irAE is warranted. With heightened vigilance, early recognition can lead to decreased mortality and morbidity.
Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Antineoplásicos Imunológicos
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Nivolumabe
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Hepatite
/
Imunoterapia
Tipo de estudo:
Diagnostic_studies
/
Prognostic_studies
Limite:
Aged
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Female
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Humans
Idioma:
En
Revista:
J Oncol Pharm Pract
Assunto da revista:
FARMACIA
Ano de publicação:
2020
Tipo de documento:
Article
País de afiliação:
Estados Unidos