Successful re-administration of Pazopanib in a patient with metastatic renal cell carcinoma and a history of Pazopanib-induced nephrotic syndrome: a case report

摘要

Drug-induced nephrotic syndrome (NS) can be resolved by eliminating the causative agents. However, patients with metastatic cancer have not been previously reported to achieve complete recovery from anticancer drug-induced NS after discontinuation of treatment, because many patients die of cancer progression before NS is restored. A 67-year-old man presented with edema of both lower extremities. He received pazopanib therapy for recurrent metastatic renal cell carcinoma (mRCC) for 17?months. Laboratory examinations revealed 7484.58?mg/day of 24-h urine protein, 434?mg/dL of serum cholesterol, and 2.9?g/dL of serum albumin. He was diagnosed with NS, and pazopanib treatment was discontinued. Four months later, he completely recovered from NS. He was then treated with temsirolimus and nivolumab sequentially for ?26?months. Pazopanib was re-introduced following disease progression, and demonstrated antitumor effects for 7?months without NS recurrence. Pazopanib-induced NS can occur late in patients with mRCC, and its subsequent discontinuation can enable patients to completely recover from its adverse effects. Moreover, pazopanib treatment may be re-introduced without the recurrence of NS.