Severe immune thrombocytopenia induced by nivolumab in a patient with metastatic renal cell carcinoma

Publication date: Available online 28 January 2020Source: Urology Case ReportsAuthor(s): Shinro Hata, Satoki AbeAbstractIn the Checkmate-025 trial, nivolumab treatment prolonged overall survival among patients with previously treated advanced renal cell carcinoma (RCC) compared with treatment with everolimus. Although effective, nivolumab is associated with immune-related adverse events (irAEs). However, the occurrence of hematological irAEs is rare. Some studies have reported on nivolumab-induced thrombocytopenia. Nivolumab associated thrombocytopenia in almost all patients improved with administration of various drugs. However, there have been only a few cases that have reported death owing to cancer aggravation. In this paper, we have described a case of nivolumab-induced thrombocytopenia after third-line treatment for metastatic RCC.
Source: Urology Case Reports - Category: Urology & Nephrology Source Type: research

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We reported a 56-year-old man who presented with petechiae and ecchymoses. Laboratory studies showed the platelet count of 2 × 109/L and an abdominal computed tomography (CT) scan revealed tumors in the right renal. There were purpura on the legs and cough without abdominal pain and melena at this time. Idiopathic thrombocytopenic purpura was diagnosed according to the clinical symptoms and laboratory test. The patient received radical nephrectomy for renal carcinoma, and his idiopathic thrombocytopenic purpura was cured after the surgery. Pathological biopsy confirmed it was renal clear cell carcinoma....
Source: International Journal of Immunopathology and Pharmacology - Category: Allergy & Immunology Tags: Int J Immunopathol Pharmacol Source Type: research
ConclusionsFirst, an early detection of overt disseminated intravascular coagulation is essential, although disseminated intravascular coagulation in cancer presents as a chronic or even subclinical process with unique thrombocytopenia. Second, making a decision of systemic chemotherapy without delay at the time of disseminated intravascular coagulation diagnosis is the key to successful cancer-related disseminated intravascular coagulation treatment.
Source: Journal of Medical Case Reports - Category: General Medicine Source Type: research
Conclusions: Partial alleviation of VHL disease-related tumors can be achieved by TKI therapies in some patients, providing an alternative treatment strategy, and the side effects of TKIs are acceptable. Larger prospective studies are warranted to further evaluate the efficacy and safety of TKIs in patients with VHL disease.
Source: Frontiers in Oncology - Category: Cancer & Oncology Source Type: research
We describe, for the first time, a case of neutropenia and thrombocytopenia in a patient in treatment with cabozantinib, a novel anticancer treatment used in metastatic renal cell carcinoma, and apixaban with promptly resumption of the toxicity after the interruption of cabozantinib. This case suggest a possible interaction between these two pharmaceutical agents, which merit caution considering the spreading of the two drugs.
Source: Experimental Hematology and Oncology - Category: Cancer & Oncology Source Type: research
ConclusionAMG 172 exhibited a favorable pharmacokinetic profile in patients with relapsed/refractory ccRCC and showed evidence suggestive of limited antitumor activity. Safety and tolerability were as expected for a maytansinoid antibody-drug conjugate.
Source: Cancer Chemotherapy and Pharmacology - Category: Cancer & Oncology Source Type: research
Discussion MDSCs violently emerge in pathological conditions in an attempt to limit potentially harmful immune and inflammatory responses. Mechanisms supporting their expansion and survival are deeply investigated in cancer, in the perspective to reactivate specific antitumor responses and prevent their contribution to disease evolution. These findings will likely contribute to improve the targeting of MDSCs in anticancer immunotherapies, either alone or in combination with immune checkpoint inhibitors. New evidence indicates that the expansion of myeloid cell differentiation in pathology is subject to fine-tuning, as its...
Source: Frontiers in Immunology - Category: Allergy & Immunology Source Type: research
Conclusions: Sunitinib treatment has acceptable efficacy and safety profile in Malaysian mRCC patients. The MSKCC and IMDC factors are relevant for predicting survival in our patient cohort while HFS is a promising prognostic predictor which warrants further investigation.
Source: Journal of Cancer Research and Therapeutics - Category: Cancer & Oncology Authors: Source Type: research
We report updated results of the primary (PFS) and secondary (overall survival [OS] and toxicity) endpoints.Patients and Methods: Between 4/15/2015-1/27/2016, 27 evaluable pts were treated on 28 day cycles with ELO, 10 mg/kg iv weekly for cycles 1-2, q2weeks for cycles 3-6, then 20 mg/kg once monthly for cycles 7+. Pts enrolled after 1/28/2016 (n=57 pts) have received ELO, 10 mg/kg IV weekly for cycles 1-2, and 20 mg/kg on day 1 from cycle 3 until disease progression (PD). LEN has been dosed at 10 mg/day for cycles 1-3, with a dose increase to 15 mg/day at physician discretion starting with cycle 4, in the absence of non-h...
Source: Blood - Category: Hematology Authors: Tags: 653. Myeloma: Therapy, excluding Transplantation: Poster I Source Type: research
AbstractPatients with primary or metastatic brain tumors are at increased risk of developing venous thromboses. However, the potential benefit of therapeutic anticoagulation in these patients must be weighed against the deadly complication of intracranial hemorrhage. In this review, we summarize available evidence and recent studies of intracranial bleeding risks in primary and metastatic tumors and the impact of therapeutic anticoagulation. We find that for the majority of primary and treated metastatic brain tumors, the risk of spontaneous bleeding is acceptable and not further increased by careful therapeutic anticoagul...
Source: The Oncologist - Category: Cancer & Oncology Authors: Tags: Lung Cancer, Neuro-Oncology, Symptom Management and Supportive Care Source Type: research
Publication date: Available online 26 January 2018 Source:The Lancet Haematology Author(s): Paul M Barr, Hongli Li, W Richard Burack, Michael LeBlanc, Sonali M Smith, Ajay K Gopal, Justin D Floyd, Daniel O Persky, Oliver W Press, Richard I Fisher, Jonathan W Friedberg Background Despite an abundance of therapeutic options, advanced-stage follicular lymphoma remains incurable. Furthermore, the ideal sequence and absolute benefit of post-induction therapy is unclear. We designed SWOG S0801 to assess the efficacy and safety of consolidative radioimmunotherapy and sequential maintenance rituximab following chemoimmunotherapy....
Source: The Lancet Haematology - Category: Hematology Source Type: research
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