PD-L1-negative Non-small-cell Lung Cancer Treated with Nivolumab Plus Ipilimumab during Maintenance Hemodialysis Results in Rapid Initial Progression Followed by a Long-lasting Response

Intern Med. 2024 Apr 1;63(7):985-988. doi: 10.2169/internalmedicine.2270-23. Epub 2023 Aug 9.

Abstract

Nivolumab plus ipilimumab is one of the first-line treatments for advanced non-small-cell lung cancer (NSCLC), but the safety and efficacy in patients on hemodialysis (HD) is unclear. We herein report a patient with NSCLC on HD in whom nivolumab and ipilimumab were initiated. We observed general deterioration and enlarged lesions, followed by a long-term response. The patient developed secondary hypoadrenocorticism, an immune-related adverse event that was easily controlled. Nivolumab plus ipilimumab can be used safely for patients with NSCLC on HD. Long-term effectiveness can be observed after initial progression, so we should carefully assess the response.

Keywords: hemodialysis; immune-related adverse event; nivolumab plus ipilimumab; non-small-cell lung cancer; pseudoprogression.

MeSH terms

  • Antineoplastic Combined Chemotherapy Protocols / adverse effects
  • B7-H1 Antigen
  • Carcinoma, Non-Small-Cell Lung* / drug therapy
  • Humans
  • Ipilimumab / therapeutic use
  • Lung Neoplasms* / pathology
  • Nivolumab / therapeutic use

Substances

  • Nivolumab
  • Ipilimumab
  • B7-H1 Antigen