Kidney Injury During Nivolumab Treatment for Stage IV Gastric Cancer
This gastric cancer diagnosis at a glance
- Stage at diagnosis
- Stage IV
- Sex
- Male
- Treatment
- chemotherapy, targeted therapy and immunotherapy
- Outcome
- Setback / Progression
Treatment course, step by step
- He received S-1 with oxaliplatin, followed by paclitaxel and ramucirumab.
- Nivolumab was paused for kidney injury, restarted after recovery, and later stopped when the cancer progressed.
- Treatment then changed to irinotecan.
What happened, in summary
A 68-year-old man had been diagnosed with stage IV gastric cancer 11 months before a hospital admission. He first received 6 months of S-1, a combination of tegafur, gimeracil, and oteracil, with oxaliplatin. He then received paclitaxel and ramucirumab for 3 months, but neither regimen produced much benefit. Nivolumab was started at 3 mg/kg every 2 weeks.
Within 2 months of starting nivolumab, urine testing showed increasing protein and blood. He lost 3 kg, developed diarrhea, and his creatinine rose from 0.77 to 1.96 mg/dL. A kidney biopsy showed glomerular endothelial injury. Nivolumab was stopped. Steroids were not used because dehydration was also thought to contribute and the biopsy changes were not severe.
His kidney function gradually improved, and proteinuria disappeared about 6 weeks after nivolumab was stopped. Because the cancer had progressed, nivolumab was restarted, but it was ineffective. His oncologist then changed treatment to irinotecan. Blood in the urine eventually resolved 7 months after the final nivolumab dose.
Where this story comes from
This is a lay summary of an account first published by PMC / PubMed Central. Read the original in full
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Collections this story belongs to
- Stage 4 Gastric Cancer 72 stories
- Chemotherapy for Gastric Cancer 98 stories
These are lay summaries of published cancer stories, for information only. No two cancers behave the same way, and nothing here predicts your own diagnosis or replaces advice from your oncology team. Read the full disclaimer