CASE REPORT article
Front. Oncol.
Sec. Pharmacology of Anti-Cancer Drugs
Volume 15 - 2025 | doi: 10.3389/fonc.2025.1561440
This article is part of the Research TopicEvidence-Based Research and Clinical Application of Adverse Reactions and Management Strategies for Cancer Treatment DrugsView all 11 articles
Acute thrombocytopenia and fibrinogen reduction occurring after Nintedanib treatment for immune checkpoint inhibitor-related pneumonia: a case report
Provisionally accepted
- 1Second Affiliated Hospital, Zhejiang Chinese Medical University, Hangzhou, China
- 2The Traditional Chinese Medicine Hospital of Linping District, Hangzhou, Jiangsu Province, China
Select one of your emails
You have multiple emails registered with Frontiers:
Notify me on publication
Please enter your email address:
If you already have an account, please login
You don't have a Frontiers account ? You can register here
Background: Nintedanib, a small molecule multi-target tyrosine kinase inhibitor, can block the fibrosis process and slow disease progression. Acute thrombocytopenia and fibrinogen reduction caused by nintedanib is a rare clinical event, with few studies reported. Case Presentation: We report the case of an 89-year-old male diagnosed with advanced renal cell carcinoma who developed immune-related interstitial lung disease after treatment with sintilimab injection combined with axitinib. After prescribed nintedanib treatment, the patient's platelet count decreased from 241×10 μ g/L to 49×10 μ g/L and fibrinogen decreased from 5.61 g/L to 0.76 g/L. Based on the patient's medical history, laboratory test results, and examination results, the diagnosis was made that it was nintedanib-induced reduction in platelet and fibrinogen levels. After discontinuation of nintedanib, the patient's platelets and fibrinogen returned to normal, and no further reduction in platelets and fibrinogen was observed during the follow-up period. This case report suggests to physicians that if there is an unexplained decrease in platelet and fibrinogen levels during nintedanib treatment, nintedanib-induced factors should be considered. Conclusion: Thrombocytopenia and fibrinogens abnormal are rare but serious adverse effect of nintedanib. This case highlights the importance of early recognition and monitoring of platelet counts and coagulation function in patients receiving nintedanib. Suspect drug discontinuation and active supportive care are essential. Further research is needed to elucidate the underlying mechanisms and then make corresponding treatment recommendations.
Keywords: drug-induced thrombocytopenia, Fibrinogens abnormal, Checkpoint inhibitor pneumonitis, Nintedanib, case report
Received: 15 Jan 2025; Accepted: 24 Jul 2025.
Copyright: © 2025 Zheng, Zhou and Pang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Jian Zheng, Second Affiliated Hospital, Zhejiang Chinese Medical University, Hangzhou, China
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.