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- Title
Bevacizumab-Induced Thrombotic Microangiopathy (TMA) in Metastatic Lung Adenocarcinoma Patients Receiving Nivolumab Combined with Bevacizumab, Carboplatin and Paclitaxel: Two Case Reports.
- Authors
Hsu, Ping-Chih; Chen, Tai-Di; Tsai, Tsung-Yu; Yang, Cheng-Ta
- Abstract
Anti-programmed death-1 (PD-1)/programmed death ligand 1 (PD-L1) immune checkpoint inhibitors (ICIs), combined with bevacizumab and platinum-based chemotherapy, have shown promising efficacy in treating metastatic non-squamous cell lung cancer in phase 3 clinical trials. However, drug-induced nephrotoxicity is an uncommon but threatening adverse effect when using this combination therapy, and should be evaluated and managed carefully. Here, we present two patients experiencing late-onset asymptomatic heavy proteinuria during the clinical trial. Kidney biopsies performed finally identified bevacizumab-induced thrombotic microangiopathy (TMA), and the proteinuria was decreased after discontinuing bevacizumab permanently. Our report suggests that a kidney biopsy is needed for those receiving ICIs in combination with bevacizumab and chemotherapy and experiencing nephrotoxicity such as heavy proteinuria.
- Subjects
BEVACIZUMAB; NIVOLUMAB; IMMUNE checkpoint inhibitors; PACLITAXEL; CARBOPLATIN
- Publication
Clinics & Practice, 2023, Vol 13, Issue 1, p200
- ISSN
2039-7283
- Publication type
Case Study
- DOI
10.3390/clinpract13010018