Use of PD-1 inhibitors in patients with end-stage renal disease: safety and clinical outcomes from real-world data

Wang, Jiasheng; Dasari, Srilatha; Elantably, Dina; Alkrekshi, Akram; Kim, Yeseong David

doi:10.1080/0284186x.2022.2127121

Cited by 4 publications

(3 citation statements)

References 24 publications

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“…Atezolizumab at full dose has been used successfully in multiple case reports of patients with dialysis. Data from a large real-world database of patients receiving PD-1 inhibitors for lung, renal, bladder, head and neck or melanoma, showed no increased rate of immune-related adverse events in patients with ESKD versus those without ( 20 ). Whilst immune checkpoint inhibitors can be given in patients with ESKD receiving dialysis, important consideration must be given to patients with previous kidney transplants as immune checkpoint inhibition can precipitate transplant rejection and allograft failure ( 15 ).…”

Section: Discussionmentioning

confidence: 99%

Case report: Successful treatment of a patient undergoing haemodialysis with multifocal hepatocellular carcinoma using atezolizumab and bevacizumab

Abraham,

Samson

2024

Front. Oncol.

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In the last five years, the advent of combination immune checkpoint inhibitor atezolizumab and anti-angiogenic agent bevacizumab has transformed treatment of unresectable hepatocellular carcinoma. As patient outcomes improve, healthcare professionals will more frequently encounter patients with concomitant hepatocellular cancer and end stage kidney disease on haemodialysis. We present the first case in the literature of a 58-year-old male with multifocal hepatocellular carcinoma undertaking regular haemodialysis who was successfully treated with atezolizumab and bevacizumab with a partial response and stable disease for two years, who suffered grade 1 fatigue, grade 2 hypertension and eventually grade 3 wound infection leading to cessation of bevacizumab. After disease progression on atezolizumab monotherapy, all chemotherapy was stopped. We embed this case in a review of the current literature of atezolizumab and bevacizumab use in patients undertaking haemodialysis and conclude that both targeted therapies may be safely used in these patients. We recommend joint close management of these patients between oncology and nephrology teams, with initial cardiovascular risk stratification before commencing atezolizumab and bevacizumab therapy. During therapy, there should be regular monitoring of blood pressure, or proteinuria if the patient is oliguric under guidance of the dialysis team if preservation of residual renal function is required.

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Section: Discussionmentioning

confidence: 99%

Case report: Successful treatment of a patient undergoing haemodialysis with multifocal hepatocellular carcinoma using atezolizumab and bevacizumab

Abraham,

Samson

2024

Front. Oncol.

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“…While there is limited data on the safety of ICIs in dialysis patients, A previous study using a large real‐world database demonstrated that the incidences of irAEs were comparable between end‐stage renal disease (ESRD) and non‐ESRD groups in patients diagnosed with lung, renal cell, bladder, head/neck cancer or melanoma treated with pembrolizumab or nivolumab 7 . ICIs exhibit prolonged half‐lives and are excreted via receptor‐mediated endocytosis or pinocytosis facilitated by the endothelial reticulum system 7 . Moreover, the metabolism of ICIs remains unaffected by dialysis due to their substantial molecular sizes (atezolizumab: 145 kDa) 8 .…”

Section: Discussionmentioning

confidence: 99%

“… 7 ICIs exhibit prolonged half‐lives and are excreted via receptor‐mediated endocytosis or pinocytosis facilitated by the endothelial reticulum system. 7 Moreover, the metabolism of ICIs remains unaffected by dialysis due to their substantial molecular sizes (atezolizumab: 145 kDa). 8 Considering pharmacokinetics, it is reasonable to infer that the utilization of ICIs in dialysis patients is generally well‐tolerated.…”

Section: Discussionmentioning

confidence: 99%

Successful treatment with atezolizumab in a haemodialysis patient with large cell neuroendocrine carcinoma

Imai

Kitamura

2023

Respirology Case Reports

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In this report, a modified regimen based on IMpower 133 (carboplatin + etoposide + atezolizumab) was administered to a patient diagnosed with large cell neuroendocrine carcinoma (LCNEC) who was concurrently undergoing haemodialysis. Adverse events led to the discontinuation of carboplatin and etoposide after the first course. Nevertheless, the patient exhibited reduction in pulmonary nodule and adrenal metastasis while receiving atezolizumab, indicating its sustained efficacy for a duration of 7 months. To the best of our knowledge, this is the first documented case demonstrating successful treatment with atezolizumab in LCNEC patients undergoing haemodialysis. Atezolizumab can be administered safely in patients undergoing dialysis and is a promising therapeutic option for dialysis patients with LCNEC.

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Safety and efficacy of atezolizumab plus bevacizumab combination therapy in patients with unresectable hepatocellular carcinoma undergoing dialysis: a case series

Sakaguchi,

Satoh,

Kawaguchi

et al. 2024

Clin J Gastroenterol

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Use of PD-1 inhibitors in patients with end-stage renal disease: safety and clinical outcomes from real-world data

Cited by 4 publications

References 24 publications

Case report: Successful treatment of a patient undergoing haemodialysis with multifocal hepatocellular carcinoma using atezolizumab and bevacizumab

Case report: Successful treatment of a patient undergoing haemodialysis with multifocal hepatocellular carcinoma using atezolizumab and bevacizumab

Successful treatment with atezolizumab in a haemodialysis patient with large cell neuroendocrine carcinoma

Safety and efficacy of atezolizumab plus bevacizumab combination therapy in patients with unresectable hepatocellular carcinoma undergoing dialysis: a case series

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