A case of rhabdomyolysis after nivolumab treatment for hypopharyngeal carcinoma

DOI
  • INAMO Mana
    Department of Otorhinolaryngology, Kanagawa Children's Medical Center Department of Otorhinolaryngology, Head and Neck Surgery, Yokohama City University Graduate School of Medicine
  • HATANO Takashi
    Department of Otorhinolaryngology, Head and Neck Surgery, Yokohama City University Graduate School of Medicine
  • TAKAHASHI Hideaki
    Department of Otorhinolaryngology, Head and Neck Surgery, Yokohama City University Graduate School of Medicine
  • SANO Daisuke
    Department of Otorhinolaryngology, Head and Neck Surgery, Yokohama City University Graduate School of Medicine
  • TOKUHISA Motohiko
    Department of Oncology, Yokohama City University Graduate School of Medicine
  • NISHIMURA Goshi
    Department of Otorhinolaryngology, Head and Neck Surgery, Yokohama City University Graduate School of Medicine
  • ORIDATE Nobuhiko
    Department of Otorhinolaryngology, Head and Neck Surgery, Yokohama City University Graduate School of Medicine

Bibliographic Information

Other Title
  • 再発転移下咽頭癌に対しニボルマブ投与後に発症した横紋筋融解症の 1 例

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Description

<p>A 62-year-old man who was initially diagnosed with Stage IVa squamous cell cancer of the hypopharynx, received concurrent chemoradiotherapy with cisplatin. As local recurrence was subsequently observed, he underwent total laryngopharyngectomy with free flap reconstruction. However, unresectable cervical lymph node metastasis was observed 3 months after the surgery. He was therefore treated with nivolumab as first-line therapy. As disease progression was observed after 4 courses of nivolumab, he was then treated with paclitaxel plus cetuximab as second-line therapy. He suddenly lost consciousness at home 2 days after 8 courses of the chemotherapy (11 months after the first administration of nivolumab). As elevated CK was observed in the laboratory test on admission, immune-related adverse events were initially suspected. The patient died without showing a response to steroid therapy, ventilator management, continuous hemodiafiltration and other treatments. The autopsy revealed a lack of cross-striation of skeletal muscle, indicating the existence of rhabdomyolysis. Although there have been few reports on rhabdomyolysis after nivolumab treatment date, this immune-related adverse events (irAEs) may be a potentially fatal adverse event.</p>

Journal

  • jibi to rinsho

    jibi to rinsho 67 (3), 193-199, 2021-05-20

    JIBI TO RINSHO KAI

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