Case Report: Resolution of remitting seronegative symmetrical synovitis with pitting edema during nivolumab therapy for gastric cancer.

The anti-programmed cell death-1 (PD-1) antibody nivolumab has been shown to significantly prolong the survival of patients with unresectable advanced or recurrent gastric cancer (AGC). However, immune-related adverse events (irAEs), which show different profiles from those of cytotoxic agents or conventional molecular-targeted drugs including tyrosine kinase inhibitors, have been reported. Remitting seronegative symmetrical synovitis with pitting edema (RS3PE) is a rare autoimmune disorder with acute-onset, rheumatoid factor-negative, symmetric synovitis associated with limb edema observed in elderly persons. A case of RS3PE syndrome that developed after administration of nivolumab for advanced gastric cancer is reported. This is the first report of a case of RS3PE syndrome as an irAE caused by nivolumab in a patient with gastric cancer.
Competing Interests: HA: Speakers’ bureau from Ono Pharmaceutical and Bristol-Myers Squibb, KT: Speakers’ bureau from Ono Pharmaceutical, MA: Speakers’ bureau from Bristol-Myers Squibb, HN: Honoraria from Ono Pharmaceutical and Bristol-Myers Squibb and Speakers’ bureau from Ono Pharmaceutical and Bristol-Myers Squibb, KA: Lecture fees from Ono Pharmaceutical and Bristol-Myers Squibb, EB: Honoraria from Ono Pharmaceutical and Bristol-Myers Squibb. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
(Copyright © 2023 Ohmura, Kondo, Uenomachi, Ariyama, Ito, Tsuchihashi, Ayano, Niiro, Akashi and Baba.)