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Early Recognition of Immune-Related Hepatitis During Avelumab Maintenance Therapy for Urothelial Carcinoma
Yuka Iwama1, Tomoyasu Sano1, Yuta Sano1
1Department of Urology Nagoya University Nagoya Aichi Japan.
Introduction:
Avelumab is recommended as maintenance therapy for advanced urothelial carcinoma after platinum chemotherapy; however, immune-related adverse events can be severe and refractory.
Case Presentation:
A 79-year-old male developed immune-related hepatitis during avelumab maintenance therapy following gemcitabine plus carboplatin for metastatic recurrent urothelial carcinoma. Despite discontinuation of avelumab and treatment with high-dose corticosteroids, mycophenolate mofetil, and plasma exchange, liver failure progressed, leading to death on day 106.
Conclusion:
Hepatic irAEs during avelumab therapy are rare but potentially fatal. Early recognition and aggressive multidisciplinary management are essential to improve outcomes.
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