1 © Copyright iMedPub | This artcle is available in: htp://www.hsj.gr/ 2020 Health Science Journal ISSN 1791-809X Vol. 14 No. 7: 780 iMedPub Journals www.imedpub.com Case Report DOI: 10.36648/1791-809X.14.7.780 Nivolumab and Acute Grade III Renal Toxicity Abstract Background: Immune-checkpoint-inhibitors (ICPIs) represent a novel class of immunotherapy against several malignancies that changed the treatment of cancer and improved the patent’s outcome. However these agents are associated with several "immune-mediated" adverse efects, of which, acute kidney injury (AKI) is quite rare. Case report: A 58-year old patent diagnosed with advanced NOS/NSCLC, and not receiving any other medicaton, experienced a decline in the renal functon afer four cycles with nivolumab. Afer ruling out other common causes of intersttal nephrits, was atributed as a cause of intersttal nephrits, confrmed by the renal biopsy. The patent discontnued immunotherapy and he was treated with intravenous prednisolone. There was a slight decrease in creatnine values and he contnued treatment at home. Two months later creatnine values had returned to normal, but unfortunately, the patent died from an acute heart atack. Conclusions: AKI is a possible but rare complicaton of immunotherapy which may require discontnuaton of ICPIs and cortcosteroid treatment. Keywords: Immunotherapy; Renal failure; Cancer Michael Vaslamatzis 1 *, Theodoros Tegos 1 , Natalia Asimakopoulou 1 , Theodora Ikonomaki 2 , Vassiliki Nikolaidou 1 , Christina- Danai Skondra 2 , Stavros Pantelakos 3 , Konstantinos Kotsifas 4 , Konstantina Karagiorgou 1 , Konstantinos Folinas 1 ,George Karkaletsos 1 , Aleksandra Tsirogianni5, Charalampos Zoumplios 1 , Christina Vourlakou 3 and Nektarios Alevizopoulos 1 1 Department of Oncology, Evangelismos Hospital, Athens, Greece 2 Department of Nephrology, Evangelismos Hospital, Athens, Greece 3 Department of Pathology, Evangelismos Hospital, Athens, Greece 4 Department of Respiratory, Evangelismos Hospital, Athens, Greece 5 Department of Immunology, Evangelismos Hospital, Athens, Greece *Corresponding author: Michael M Vaslamatzis  michaelvaslamatzis@gmail.com Tel: 00302132041824 Head of the Oncology Department, Evangelismos General Hospital, Greece. Citation: Vaslamatzis M, Tegos T, Asimakopoulou N, Ikonomaki T, Nikolaidou V, et al. (2020) Nivolumab and Acute Grade III Renal Toxicity. Health Sci J. 14 No. 7: 780. Received with Revision November 09, 2020, Accepted: November 23, 2020, Published: November 27, 2020 Introducton Novel antcancer therapies include immune check point inhibitors ant-programmed cell death protein-1 (PD-1), ant-programmed death ligand-1 (PD-L1) and cytotoxic T lymphocyte-associated antgen 4 (CTLA-4) drugs. The recent emergence of immune check point inhibitors (ICPIs), represents an emerging class of immunotherapy used in treatng malignant solid tumors and hematologic malignancies and they recommend a substantal advance in oncology. These drugs have recently been approved for use in many advanced malignant neoplasms, mainly in non- small cell lung cancer (NSCLC), melanoma, renal-cell carcinoma, Hodgkin lymphoma, and many other malignancies. ICPIs are monoclonal antbodies that target inhibitory receptors expressed on T cells, other immune cells, and tumor cells. CTLA-4 prevents T cell actvaton by outcompetng CD28 for its ligand, B7, there by inhibitng T cell co-stmulaton, whereas PD-1 down-regulates efector T cell functon by engaging its 2 ligands, PD-L1 and PD- L2. The most common side efects include rash, colits, hepatts, and hypophysits [1,2]. Sparse case reports have described acute kidney injury (AKI) related to ICPIs. The most common pathology fnding adverse efect from the kidney, is acute intersttal nephrits (AIN). Generally there are no diagnostc criteria are available to distnguish AIN associated with ant-PD-1 therapy from other AINs [3]. Aim The aim of this study was to present one case of AKI in patent with