@Article{,
AUTHOR = {Ying Yan Zhong, Luke McLean, Andrew Buckle, Shankar Siva, Ben Tran},
TITLE = {Vanishing bile duct syndrome associated with pazopanib after progression on pembrolizumab},
JOURNAL = {Canadian Journal of Urology},
VOLUME = {27},
YEAR = {2020},
NUMBER = {4},
PAGES = {10339--10341},
URL = {http://www.techscience.com/CJU/v27n4/60387},
ISSN = {1488-5581},
ABSTRACT = {Pazopanib, a tyrosine kinase inhibitor, has been a 
standard first-line treatment for metastatic renal cell 
carcinoma (mRCC). Recent trials combining pazopanib 
with programmed cell death protein 1 (PD-1) inhibitors, 
including pembrolizumab, have shown excessive 
hepatotoxicity. We report a case of fatal hepatotoxicity from vanishing bile duct syndrome (VBDS) associated 
with pazopanib treatment, in a patient previously exposed 
to pembrolizumab. This is the first report of pazopanibinduced VBDS. We postulate whether prior exposure to 
pembrolizumab predisposed towards pazopanib-induction 
of VBDS, and discuss potential risks of sequential 
PD-1 inhibitor followed by pazopanib in mRCC, due to 
prolonged half-lives of PD-1 inhibitors.},
DOI = {}
}