Carboplatin, Etoposide, and Durvalumab for Extensive-Stage Small Cell Lung Cancer in a Patient Undergoing Maintenance Hemodialysis: A Case Report

Abstract

Introduction: Patients undergoing maintenance hemodialysis exhibit a unique immunological state characterized by chronic inflammation and T-cell dysfunction. Evidence regarding the efficacy and safety of combination chemoimmunotherapy in dialysis patients remains extremely limited. Case Report: We report a case of extensive-stage small cell lung cancer (ES-SCLC; performance status 1, cT1cN2M1c, stage IVB) in a patient undergoing maintenance hemodialysis who received four cycles of carboplatin (300 mg/m², day 1), etoposide (50 mg/m², days 1 and 3), and durvalumab (1,500 mg/body, day 1). Treatment was safely continued after adjusting the dosing schedule and dose levels in accordance with the dialysis schedule. Although new brain metastases developed during treatment and whole-brain radiotherapy was administered, computed tomography after four cycles demonstrated a partial response, and durvalumab maintenance therapy was subsequently continued. Grade 4 thrombocytopenia and grade 3 anemia and neutropenia were observed as adverse events; however, these were manageable with transfusion support and dose reduction. Disease progression was subsequently observed. Conclusion: Carboplatin, etoposide, and durvalumab can provide meaningful therapeutic benefit even in patients undergoing maintenance hemodialysis when adverse events are appropriately managed.