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Various toxicities: case report A 32-year-old woman developed nocturnal wheezing and eosinophilia during treatment with ipilimumab and nivolumab for metastatic renal cell carcinoma (mRCC). Additionally, she developed nausea, gastric distress and had increased troponin-I level during treatment with nivolumab [durations of treatments to reactions onsets not stated]. The woman, who was diagnosed with mRCC, schedule to receive immunotherapy with IV nivolumab 240mg and IV ipilimumab 1 mg/kg every 3 weeks for four doses, followed by nivolumab monotherapy 240mg every 2 weeks in August 2019. After the initiation of treatment with nivolumab and ipilimumab, she developed nocturnal wheezing and a laboratory investigation revealed eosinophilia, which indicates immune-related adverse events associated with nivolumab and ipilimumab. During this time the other laboratory findings were normal. After three doses of nivolumab and ipilimumab, the left renal tumor had significantly shrunk. Also, the right renal hilar lymph nodes and renal tumor had disappeared, the cardiac tumor showed attenuation of contrast enhancement with no change in size. The woman was treated with budesonide and tulobuterol while continuing nivolumab and ipilimumab, which improved her respiratory symptoms; however, the eosinophilia persisted. After the completion of immunotherapy with nivolumab and ipilimumab, she started receiving monotherapy with nivolumab. After two doses of nivolumab monotherapy, she experienced gastric distress and nausea. A laboratory investigation revealed increase in troponin-I levels. Subsequently, the treatment with nivolumab was discontinued, and she was treated with prednisolone. Thereafter, her clinical symptoms and abnormal laboratory findings (increased troponin-I and eosinophilia) progressively recovered. Later, her carcinoma improved and restart of nivolumab monotherapy was planned. Shirotake S, et al. Efficacy of nivolumab plus ipilimumab in a patient with renal cell carcinoma concomitant with cardiac metastasis: A case report. In Vivo 34: 1475-1480, 803497438 No. 3, May-Jun 2020. Available from: URL: http://doi.org/10.21873/invivo.11932

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Reactions 22 Aug 2020 No. 1818