Key result
Nivolumab therapy triggers non-malignant pericardial effusion requiring pericardiocentesis in renal cell carcinoma.
Case Report (n=1)
Case of post-nivolumab chest discomfort in metastatic RCC signals possible cardiotoxicity; leaves open need for prospective cardiac monitoring studies.
A 72-year-old female with left renal cell carcinoma and lymphadenopathy had undergone hand-assisted laparoscopic left nephrectomy and dissection of the lymph node (papillary renal cell carcinoma, type 2, pT3a pN2 M1). She had been treated with adjuvant chemotherapy with sunitinib, temsirolimus and pazopanib. However, the patient was started on nivolumab due to disease progression. After receiving 5 cycles of nivolumab, she was admitted to our emergency room for chest discomfort and appetite loss. Since computed tomographic (CT) scan showed pericardial effusion, we performed pericardiocentesis. Cytological examination of the pericardial effusion demonstrated leukocytes and no malignant cells. CT scan two weeks after cardiocentesis showed no recurrent pericardial effusion. She became stable with nivolumab, but the administration of nivolumab was discontinued and she started receiving axitinib.
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Fukae et al. (2019) conducted a case report in Metastatic Renal Cell Carcinoma (n=1). Nivolumab was evaluated. Nivolumab therapy for metastatic renal cell carcinoma induced a non-malignant pericardial effusion in a 72-year-old female after 5 cycles, requiring pericardiocentesis and discontinuation.
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