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Safety and efficacy of immune checkpoint inhibitors for end-stage renal disease patients undergoing dialysis: a retrospective case series and literature review

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Summary

Despite the lack of safety and efficacy data regarding immune checkpoint inhibitors (ICIs) for renal dysfunction, they have been approved to treat even in the patients with end-stage renal disease (ESRD). We report our experience with ICI administration to three ESRD patients undergoing hemodialysis. One of the patients had a partial response for several months; however, the other patients had a stable disease while undergoing dialysis. The toxicity was tolerable; however, one patient developed grade 2 pneumonitis. A literature review of other rarely reported cases of hemodialysis revealed that 10 out of 13 patients had a partial response or complete response; in addition, grade 3 or grade 4 immune-related adverse events occurred in 3 patients. ESRD combined with dialysis may not be a contraindication for the use of ICIs. ICIs can be beneficial to ESRD patients undergoing dialysis. However, caution is needed regarding immune-related adverse events. Further prospective studies involving pharmacokinetic analyses are necessary to obtain reliable safety and efficacy data.

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This research did not receive any specific grant from any funding agencies in the public, commercial, or not-for-profit sectors.

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Authors and Affiliations

  1. Seoul National University College of Medicine, Seoul, South Korea

    Hyeon Cheun

  2. Department of Internal Medicine, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 110-744, South Korea

    Miso Kim, Hajeong Lee, Kook-Hwan Oh & Bhumsuk Keam

  3. Cancer Research Institute, Seoul National University, Seoul, South Korea

    Bhumsuk Keam

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  1. Hyeon Cheun
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  2. Miso Kim
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Correspondence to Bhumsuk Keam.

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Research involving human participants

This work was performed in humans with approval from the Institutional Review Board.

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The Institutional Review Board granted a waiver for this retrospective study.

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Cheun, H., Kim, M., Lee, H. et al. Safety and efficacy of immune checkpoint inhibitors for end-stage renal disease patients undergoing dialysis: a retrospective case series and literature review. Invest New Drugs 37, 579–583 (2019). https://doi.org/10.1007/s10637-018-0673-y

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  • DOI: https://doi.org/10.1007/s10637-018-0673-y

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