Three Cases of Nivolumab Plus Ipilimumab Therapy in Haemodialysis Patients With Metastatic Renal Cell Carcinoma.

BACKGROUND: Although the CheckMate 214 trial affirmed the effectiveness of nivolumab-ipilimumab combination therapy in advanced or metastatic renal cell carcinoma (mRCC), its safety and efficacy in patients with end-stage renal disease (ESRD) on haemodialysis remains unexplored. CASE REPORT: All patients were male and underwent mRCC treatment with partial nephrectomy or nephrectomy. They had ESRD and were undergoing haemodialysis. Cases 1 and 2 showed lymph node and lung metastases after initial surgery and received nivolumab-ipilimumab therapy. Case 1 had grade 3 adrenal insufficiency after four courses, which was controlled with steroids. Case 2 did not experience adverse events. Both were well controlled with complete (CR) or partial response (PR). Case 3 suffered local recurrence after nephrectomy and received combination therapy. Grade 3 adrenal insufficiency occurred following three courses, and tumour size did not change remarkably.
CONCLUSION: Nivolumab-ipilimumab combination therapy can effectively treat mRCC patients with ESRD undergoing haemodialysis.