Cytokine release syndrome treated with tocilizumab following ipilimumab–nivolumab combination therapy in advanced renal cell carcinoma

Q4 Medicine IJU Case Reports Pub Date : 2024-11-29 DOI:10.1002/iju5.12812

Toru Inoue, Akiko Todaka, Masahiro Fuse, Shuntaro Suzuki, Shinya Sejiyama, Tadasuke Ando, Toshitaka Shin

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Abstract

Introduction

Cytokine release syndrome is a rare but potentially life-threatening complication of immune checkpoint inhibitor therapy. Its occurrence in renal cell carcinoma treated with combination therapy is less recognized and poses significant management challenges.

Case presentation

A 50-year-old male with metastatic renal cell carcinoma developed severe cytokine release syndrome after receiving ipilimumab–nivolumab combination therapy. The patient presented with high fever, fatigue, and elevated inflammatory markers. Early recognition and prompt intervention with tocilizumab led to rapid clinical improvement.

Conclusion

This case highlights the importance of increased awareness, prompt recognition, and targeted management of cytokine release syndrome in renal cell carcinoma patients receiving immune checkpoint inhibitor combination therapy. The rapid response to tocilizumab suggests its potential efficacy in managing immune checkpoint inhibitor-induced cytokine release syndrome.

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依匹单抗-纳沃单抗联合治疗晚期肾细胞癌后，托珠单抗治疗细胞因子释放综合征。

细胞因子释放综合征是免疫检查点抑制剂治疗中一种罕见但可能危及生命的并发症。它在联合治疗的肾细胞癌中发生的认识较少，并提出了重大的管理挑战。病例介绍：一名50岁男性转移性肾癌患者在接受伊匹单抗-纳沃单抗联合治疗后出现严重的细胞因子释放综合征。患者表现为高热、疲劳和炎症标志物升高。tocilizumab的早期识别和及时干预导致了快速的临床改善。结论：本病例强调了在接受免疫检查点抑制剂联合治疗的肾癌患者中提高对细胞因子释放综合征的认识、及时识别和靶向管理的重要性。对tocilizumab的快速反应表明其在控制免疫检查点抑制剂诱导的细胞因子释放综合征方面的潜在功效。

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