Cytokine Release Syndrome with Relative Adrenal Insufficiency Induced by Ipilimumab and Nivolumab Combination Therapy for Clear Cell Renal Cell Carcinoma

Combination therapy with ipilimumab and nivolumab is indicated for many types of cancers; however, several patients experience immune-related adverse events (irAEs). We herein report a case of cytokine release syndrome (CRS) in a 63-year-old woman with stage IV left clear cell renal cell carcinoma....

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Bibliographic Details
Published in:Internal Medicine 2024/10/01, Vol.63(19), pp.2703-2707
Main Authors: Yamamoto, Kohei, Shiotsu, Shinsuke, Sasakura, Misaki, Tanaka, Shunya, Goda, Shiho, Tsuji, Taisuke, Yuba, Tatsuya, Takumi, Chieko, Hiraoka, Noriya
Format: Article
Language:English
Subjects:
adrenal insufficiency
Case Report
Case reports
Clear cell-type renal cell carcinoma
Corticosteroids
cytokine release syndrome
Cytokines
immune-related adverse event
ipilimumab
nivolumab
Prednisolone
Steroid hormones
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Summary:Combination therapy with ipilimumab and nivolumab is indicated for many types of cancers; however, several patients experience immune-related adverse events (irAEs). We herein report a case of cytokine release syndrome (CRS) in a 63-year-old woman with stage IV left clear cell renal cell carcinoma. Our patient developed CRS while taking prednisolone, 43 days after the start of ipilimumab and nivolumab administration. The patient was treated with steroid pulse therapy, which improved the symptoms of shock and respiratory failure. Increased vascular permeability and relative adrenal insufficiency are considered to be the main pathogeneses. The early administration of high-dose steroids is crucial as a replacement for corticosteroids.
ISSN:0918-2918
1349-7235
1349-7235
DOI:10.2169/internalmedicine.3115-23