1. Interstitial nephritis in melanoma patients secondary to PD-1 checkpoint inhibitor
- Author
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Asaad Trabolsi, Julia Escandon, Jose Lutzky, Ayman Layka, David B. Thomas, and Stephanie Peacock
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0301 basic medicine ,Oncology ,Male ,Cancer Research ,medicine.medical_treatment ,Interstitial nephritis ,Programmed Cell Death 1 Receptor ,Case Report ,Pembrolizumab ,Immune checkpoint inhibitor ,0302 clinical medicine ,Antineoplastic Combined Chemotherapy Protocols ,Immunology and Allergy ,Neoplasm Metastasis ,Melanoma ,Antibodies, Monoclonal ,Immunosuppression ,Middle Aged ,Nivolumab ,030220 oncology & carcinogenesis ,Molecular Medicine ,Female ,Immunotherapy ,Nephritis ,medicine.drug ,medicine.medical_specialty ,Drug-Related Side Effects and Adverse Reactions ,Immunology ,Ipilimumab ,Antibodies, Monoclonal, Humanized ,03 medical and health sciences ,Internal medicine ,medicine ,Humans ,Aged ,Pharmacology ,Inflammation ,business.industry ,medicine.disease ,Immune checkpoint ,Programed death 1 receptor (PD-1) ,030104 developmental biology ,Nephritis, Interstitial ,business ,PD-1 ligand (PD-L1) - Abstract
Background Immune checkpoint inhibitors have become the first line therapy in melanoma treatment and their use is extending to other malignancies. However, we are still learning about immune side effects produced by these drugs and their severity especially in patients with history of inflammatory diseases. Case presentation We present two cases of metastatic melanoma treated with nivolumab and pembrolizumab (anti PD-1). Both patients developed acute interstitial nephritis during immune checkpoint therapy. We emphasize the causal association between immune checkpoint inhibitors and the nephritis. The timing of drug administration and appearance of nephritis is suggestive of a causal relation between the checkpoint inhibitor therapy and this adverse event. Conclusions Although uncommon, some side effects from checkpoint inhibitors can be severe and may need to be addressed with immunosuppression. Given the increasing frequency of immunotherapy use, awareness should be raised in regards to immune side effects and their appropriate management.
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