Fixed dosage regimen is currently the standard therapy with tyrosine kinase inhibitors (TKI). This case report demonstrates successful determination of nilotinib dosage by therapeutic drug monitoring (TDM) in a patient with chronic myeloid leukemia (CML). TDM may provide useful marker for individualized dosing of TKI for the treatment of CML.
Fixed dose regimen is currently the standard administration method for TKI. However, this case report indicated that TDM may by a useful approach to individualized dosing of TKI for the treatment of CML when initiating dialysis.
What is known and objective
Clinical cases of attenuation of opioid analgesic effect by administration of immune checkpoint inhibitors has not been reported. We present a case of head and neck cancer under pain management with opioids, in which cancer pain was exacerbated after administration of nivolumab.
Case summary
A male patient with head and neck cancer was hospitalized for the second‐line treatment of nivolumab. He had complained of head and neck pain after admission, but the pain was especially worse after nivolumab administration. The dose of opioids was eventually increased by approximately 320% (morphine equivalent dose) compared to before administering nivolumab.
What is new and conclusion
When administering immune checkpoint inhibitors such as nivolumab in clinical practice, the possibility of attenuation of opioid analgesic effect should be considered.
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