The effect of intermittent hemodialysis (IHD) on nivolumab serum concentrations in patients with severe renal impairment is largely unknown. Here, we present a 79-year-old patient with metastatic melanoma and end-stage renal disease on IHD three times a week, treated with 480 mg nivolumab every 4 weeks. A serum trough concentration of nivolumab was determined before the start of the third cycle, and two samples were taken immediately before and after a hemodialysis session during this cycle. All nivolumab serum concentrations were within a similar range as those previously measured among patients without renal insufficiency, after a comparable duration of nivolumab treatment. Therefore, we conclude that IHD does not influence nivolumab exposure. Furthermore, nivolumab treatment was continued without complications and appears to be well tolerated for patients on IHD. Received 22 March 2021 Accepted 24 July 2021 Correspondence to Robin van Geel, PharmD, PhD, Department of Clinical Pharmacy & Toxicology, Maastricht University Medical Center, P. Debyelaan 25, 6229 HX the Netherlands, Tel: +0031 043 3871881; e-mail: robin.van.geel@mumc.nl Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.
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