Williams Cancer Institute

Tumor Lysis Syndrome

Tumor Lysis Syndrome

Though relatively rare, tumor lysis syndrome (TLS) should be considered and monitored for in immunotherapy cases, especially with new immunotherapy combinations in a patient with a heavy tumor burden. TLS can occur when there is a rapid destruction of cancer. It may seem like a good problem to have, but it can become very serious. The rapid destruction causes a release of materials within the cancer into the blood which, if severe and not treated properly, can become fatal. The dead tumor causes an increase in electrolytes, potassium and phosphate, with low calcium, increased uric acid and blood urea nitrogen (BUN). These breakdown products can ultimately lead to kidney failure. Due to these electrolyte issues, this can be monitored by lab analysis.
The treatment of tumor lysis syndrome is well described, and one of the most important aspects is IV hydration. I will add that oncologists are often very surprised that this can occur with immunotherapy. I have seen it in patients and had oncologists delay treatment because they did not feel it was possible. My suggestion is to make sure to get follow-up labs and if the labs suggest tumor lysis, it is best to treat it as such, as soon as possible.

Reference: Jason R. Williams, 15 Oct 2019, The Immunotherapy Revolution: The Best New Hope For Saving Cancer Patients’ Lives, https://williamscancerinstitute.com/the-immunotherapy-revolution

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