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.