{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T08:50:33Z","timestamp":1777884633606,"version":"3.51.4"},"reference-count":29,"publisher":"SAGE Publications","issue":"2","license":[{"start":{"date-parts":[[2023,12,15]],"date-time":"2023-12-15T00:00:00Z","timestamp":1702598400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Pharmacy Technology"],"published-print":{"date-parts":[[2024,4]]},"abstract":"<jats:p>Nivolumab is used to treat several different types of cancers. Although it is generally considered to be effective and well-tolerated, it has been associated with adverse effects requiring discontinuation of treatment, like many other drugs used for cancer. A 70-year-old male was switched from sunitinib to nivolumab for renal cell carcinoma. The patient developed persistent hypothyroidism, onycholysis, and pneumonitis at nivolumab cycle 6, 10, and 11, respectively. Using the Naranjo causality method, the likelihood of causality was deemed \u201cprobable\u201d for pneumonitis and hypothyroidism and \u201cpossible\u201d for onycholysis. Nivolumab was eventually discontinued due to disease progression, rather than safety concerns. Eudravigilance, the European pharmacovigilance database, was searched for all nivolumab-related individual case safety reports from Malta, up to September 4, 2023. Six reports were identified in Malta, although the 3 events identified in this case report were not reported, suggesting under-reporting in Malta. This case report identified an uncommon nivolumab adverse drug reaction (ADR), onycholysis and showed how, despite the occurrence of 3 ADRs, it was its lack of efficacy rather than its safety which led to its discontinuation in this particular patient.<\/jats:p>","DOI":"10.1177\/87551225231218164","type":"journal-article","created":{"date-parts":[[2023,12,16]],"date-time":"2023-12-16T01:35:45Z","timestamp":1702690545000},"page":"112-117","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Nivolumab Safety in Renal Cell Carcinoma: A Case Report"],"prefix":"10.1177","volume":"40","author":[{"given":"James","family":"Debono","sequence":"first","affiliation":[{"name":"Oncology Department, Sir Anthony Mamo Oncology Centre, Mater Dei Hospital, Msida, Malta"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dustin","family":"Balzan","sequence":"additional","affiliation":[{"name":"Pharmacy Directorate, Mater Dei Hospital, Msida, Malta"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John Joseph","family":"Borg","sequence":"additional","affiliation":[{"name":"Malta Medicines Authority, San \u0120wann, Malta"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stephen","family":"Falzon","sequence":"additional","affiliation":[{"name":"Pharmacy Directorate, Mater Dei Hospital, Msida, Malta"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dania","family":"al-Haddad","sequence":"additional","affiliation":[{"name":"Pharmacy Directorate, Mater Dei Hospital, Msida, Malta"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Benjamin","family":"Micallef","sequence":"additional","affiliation":[{"name":"Malta Medicines Authority, San \u0120wann, Malta"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9622-169X","authenticated-orcid":false,"given":"Janet","family":"Sultana","sequence":"additional","affiliation":[{"name":"Pharmacy Directorate, Mater Dei Hospital, Msida, Malta"},{"name":"Exeter College of Medicine and Health, University of Exeter, Exeter, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2023,12,15]]},"reference":[{"key":"bibr1-87551225231218164","unstructured":"European Medicines Agency. 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