Severe Pneumonitis in Patient with Kidney Cancer Using Nivolumab after Influenza Vaccine - A Case Report

Nicoli Taiana Henn^1, , Julia Pastorello¹ and Marina Ractz Bueno²

¹Medical oncologist at the Hospital City of Passo Fundo- RS- BR. Street Tiradentes

²Medical resident in Oncology at the Hospital City of Passo Fundo

Cite this paper

Nicoli Taiana Henn, Julia Pastorello and Marina Ractz Bueno. Severe Pneumonitis in Patient with Kidney Cancer Using Nivolumab after Influenza Vaccine - A Case Report. American Journal of Medical Case Reports. 2017; 5(6):151-155. doi: 10.12691/AJMCR-5-6-5

Abstract

Immunotherapies are new drugs that are revolutionizing the treatment of many malignancies, among them, the kidney cancer. Because of their mechanism of action they can trigger an important inflammatory responses and immune-mediated adverse events. The safety of influenza vaccination during the use of checkpoint inhibitors is not defined. We report the case of a patient with kidney cancer who evolved unfavorably a few days after receiving the influenza immunization without the consent of the oncology specialists.

Keywords

kidney cancer, influenza immunization, Nivolumab

Copyright

This work is licensed under a Creative Commons Attribution 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/

References

[1]	Barker WH, Mullooly JP: Pneumonia and influenza deaths during epidemics: Implications for prevention. Arch Intern Med. 1982 Jan; 142(1): 85-9.
[2]	Whimbey E, Elting LS, Couch RB, Lo W, Williams L, Champlin RE, Bodey GP. Influenza A virus infections among hospitalized adult bone marrow transplant recipients. Bone Marrow Transplant. 1994 Apr;13(4):437-40.
[3]	Meerveld-Eggink A, de Weerdt O, van der Velden AM, Los M, van der Velden AW, Stouthard JM, Nijziel MR, Westerman M, Beeker A, van Beek R,Rimmelzwaan GF, Rijkers GT, Biesma DH. Response to influenza virus vaccination during chemotherapy in patients with breast cancer. Ann Oncol. 2011 Sep; 22(9): 2031-5.
[4]	Centers for Disease Control and Prevention: Prevention and control of influenza: Recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Morb Mortal Wkly Rep. 2006; (55): 1-42.
[5]	Pollyea DA, Brown JM, Horning SJ. Utility of influenza vaccination for oncology patients. J Clin Oncol. 2010 May 10; 28(14): 2481-90.
[6]	Pedrazzoli P, Baldanti F, Donatelli I, Castrucci MR, Puglisi F, N. Silvestris N and Cinieri S. Vaccination for seasonal influenza in patients with cancer: recommendations of the Italian Society of Medical Oncology (AIOM). Annals of Oncology 2014; 25: 1243-47.
[7]	Beck CR, McKenzie BC, Hashim AB, Harris RC, University of Nottingham Influenza and the ImmunoCompromised (UNIIC) Study Group and Nguyen-Van-Tam JS. Influenza Vaccination for Immunocompromised Patients: Systematic Review and Meta-analysis by Etiology. J Infect Dis. 2012 Oct; 206(8): 1250-9.
[8]	Rousseau B, Loulergue P, Mir O, Krivine A, Kotti S, Viel E, Simon T, de Gramont A, Goldwasser F, Launay O, Tournigand C. Immunogenicity and safety of the influenza A H1N1v 2009 vaccine in cancer patients treated withcytotoxic chemotherapy and/or targeted therapy: the VACANCE study. Ann Oncol. 2012 Feb; 23(2): 450-7.
[9]	Dizon DS, Krilov L, Cohen E, Gangadhar T, Ganz PA, Hensing TA, Hunger S, Krishnamurthi SS, Lassman AB, Markham MJ, Mayer E, Neuss M,Pal SK, Richardson LC, Schilsky R, Schwartz GK, Spriggs DR, Villalona-Calero MA, Villani G, Masters G. Clinical Cancer Advances 2016: Annual Report on Progress Against Cancer From the American Society of Clinical Oncology. J Clin Oncol. 2016 Mar 20; 34(9): 987-1011.
[10]	Motzer RJ, Escudier B, McDermott DF, George S, Hammers HJ, Srinivas S, Tykodi SS, Sosman JA, Procopio G, Plimack ER, Castellano D, Choueiri TK,Gurney H, Donskov F, Bono P, Wagstaff J, Gauler TC, Ueda T, Tomita Y, Schutz FA, Kollmannsberger C, Larkin J, Ravaud A, Simon JS, Xu LA, Waxman IM, Sharma P; CheckMate 025 Investigators. Nivolumab versus Everolimus in Advanced Renal-Cell Carcinoma. N Engl J Med. 2015 Nov 5; 373(19): 1803-13.
[11]	González-Rodríguez E, Rodríguez-Abreu D; Spanish Group for Cancer Immuno-Biotherapy (GETICA). Immune Checkpoint Inhibitors: Review and Management of Endocrine Adverse Events. Oncologist. 2016 Jul; 21(7): 804-16.
[12]	De Velasco G, Je Y, Bossé D, Awad MM, Ott PA, Moreira RB, Schutz F, Bellmunt J, Sonpavde GP, Hodi FS, Choueiri TK. Comprehensive Meta-analysis of Key Immune-Related Adverse Events from CTLA-4 and PD-1/PD-L1 Inhibitors in Cancer Patients. Cancer Immunol Res. 2017 Apr; 5(4): 312-8.
[13]	Nishijima TF, Shachar SS, Nyrop KA, Muss HB. Safety and Tolerability of PD-1/PD-L1 Inhibitors Compared with Chemotherapy in Patients with Advanced Cancer: A Meta-Analysis. Oncologist. 2017 Apr; 22(4): 470-9.
[14]	Immune response and adverse events to influenza vaccine in cancer patients undergoing PD-1 blockade. Abstract 112P_PR. European Lung Cancer Conference 2017. To be presented May 6, 2017.
[15]	Hibino M, Kondo T. Interstitial Pneumonia Associated with the Influenza Vaccine: A Report of Two Cases. Intern Med. 2017; 56(2): 197-201.
[16]	Umeda Y, Morikawa M, Anzai M, Sumida Y, Kadowaki M, Ameshima S, Ishizaki T. Acute exacerbation of idiopathic pulmonary fibrosis after pandemic influenza A (H1N1) vaccination. Intern Med. 2010; 49(21): 2333-6.
[17]	Working Group of the Brazilian Society of Clinical Oncology. Brazilian guidelines for the management of immune-related adverse events associated with checkpoint inhibitors. Braz J Oncol. 2017; 13(43): 1-15.