Avelumab plus Axitinib for the Treatment of Patients with End-Stage Renal Disease Undergoing Dialysis: A Retrospective Case Series and Literature Review

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Article / Publication Details

First-Page Preview

Abstract of Case Report

Received: July 21, 2022
Accepted: November 26, 2022
Published online: February 02, 2023

Number of Print Pages: 5
Number of Figures: 1
Number of Tables: 1

ISSN: 0042-1138 (Print)
eISSN: 1423-0399 (Online)

For additional information: https://www.karger.com/UIN

Abstract

Combination therapies of an immune checkpoint inhibitor and a molecular targeted agent are widely accepted as an appropriate initial systemic therapy for metastatic renal cell carcinoma (RCC), but there is little published evidence regarding the efficacy of this approach in patients with end-stage renal disease (ESRD). Here, we report three patients who were undergoing hemodialysis for ESRD whose metastatic RCC was successfully treated using avelumab plus axitinib. The patients were a 67-year-old man with swollen lymph nodes, a 65-year-old man with pleural dissemination, and a 71-year-old man with lung nodules and an infra-diaphragmatic nodule. They were administered a combination of avelumab plus axitinib as their initial systemic therapy following definitive surgical therapy. The best response of three patients was graded as partial response. No severe adverse events were identified. This is the first report of the use of combination therapy consisting of avelumab plus axitinib in patients with ESRD undergoing hemodialysis. We found that this combination was useful in such patients.

© 2023 S. Karger AG, Basel

References Hahn AW, Shah AY, Campbell MT. First-line immune-oncology combinations for metastatic clear cell renal cell carcinoma (mRCC): a systematic review of phase III clinical trials. Kidney CancerPreprint; 2021;5(4):207–17. Mielczarek Ł, Brodziak A, Sobczuk P, Kawecki M, Cudnoch-Jędrzejewska A, Czarnecka AM. Renal toxicity of targeted therapies for renal cell carcinoma in patients with normal and impaired kidney function. Cancer Chemother Pharmacol. 2021 Jun;87(6):723–42. Strohbehn IA, Lee M, Seethapathy H, Chute D, Rahma O, Guidon A, et al. Safety and efficacy of immune checkpoint inhibitors in patients on dialysis: a retrospective case series. Am J Kidney Dis. 2020 Aug;76(2):299–302. Kobayashi Y, Arai H, Honda M. Nivolumab and ipilimumab immunotherapy for hemodialysis patients with advanced renal cell carcinoma. Curr Oncol. 2020 Aug;27(4):225–8. Katsumata Y, Kawasaki Y, Tanaka K, Nakayama D, Katayama H, Shimada S, et al. Combination therapy of pembrolizumab plus axitinib for a patient on hemodialysis with metastatic renal cell carcinoma: a case report. Case Rep Oncol. 2021 Oct;14(3):1522–9. Iwaki T, Niimi A, Kano M, Kurokawa Y, Yoshizaki U, Nozaki K, et al. Safe administration of ipilimumab plus nivolumab to a dialysis patient with renal cell carcinoma. IJU Case Rep. 2021;4(1):32–5. Shaw LK, Wiele AJ, Sircar K, Wood CG, Msaouel P. Safe and effective use of nivolumab plus ipilimumab in a patient with metastatic clear-cell renal cell carcinoma with sarcomatoid dedifferentiation and end stage renal disease on hemodialysis. Cancer Treat Res Commun. 2021;27:100349. Kitchlu A, Jhaveri KD, Sprangers B, Yanagita M, Wanchoo R. Immune checkpoint inhibitor use in patients with end-stage kidney disease: an analysis of reported cases and literature review. Clin Kidney J. 2021;14(9):2012–22. Seydel F, Delecluse S, Zeier M, Holland-Letz T, Haag GM, Berger AK, et al. Efficacy and safety of checkpoint inhibitor treatment in patients with advanced renal or urothelial cell carcinoma and concomitant chronic kidney disease: a retrospective cohort study. Cancers. 2021 Apr;13(7):1623. McKernan J, Schmidt L, Rhoades M. Tolerance of oral targeted therapies in patients with metastatic renal-cell carcinoma and renal impairment. J Hematol Oncol Pharm. 2021;11(5):270–6 Article / Publication Details

First-Page Preview

Abstract of Case Report

Received: July 21, 2022
Accepted: November 26, 2022
Published online: February 02, 2023

Number of Print Pages: 5
Number of Figures: 1
Number of Tables: 1

ISSN: 0042-1138 (Print)
eISSN: 1423-0399 (Online)

For additional information: https://www.karger.com/UIN

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Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
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