Safe use of nivolumab in a patient with renal cell carcinoma and hepatitis B

Introduction Immunotherapy with checkpoint inhibitors gains a major role in bladder cancer. Because of the treatment’s immune modulatory effects, patients may develop hepatitis. Hepatitis B was an exclusion criterion in clinical trials that investigated nivolumab. Therefore, its effects and risk of hepatitis B reactivation in nivolumab are not clinically investigated in renal cell carcinoma patients with hepatitis B. Case report In this case report, we presented a metastatic renal cell carcinoma patient who was treated with anti-viral treatment for hepatitis reactivation caused by previous sunitinib therapy. After progression, nivolumab was commenced and the patient was closely monitored with hepatic function tests. Management and outcome Nivolumab was well tolerated and no treatment-related adverse effect occurred. Hepatitis or viral hepatitis reactivation was not detected. Discussion This case supports the safety of nivolumab in patients with renal cell carcinoma and viral hepatitis.