Clinicopathological characteristics of kidney injury in non-small cell lung cancer patients under combination therapy including pembrolizumab.
Acute kidney injury
Chemotherapy
Immune-related adverse events
Lung cancer
Pembrolizumab
Journal
CEN case reports
ISSN: 2192-4449
Titre abrégé: CEN Case Rep
Pays: Japan
ID NLM: 101636244
Informations de publication
Date de publication:
02 2022
02 2022
Historique:
received:
19
03
2021
accepted:
07
08
2021
pubmed:
19
8
2021
medline:
22
4
2022
entrez:
18
8
2021
Statut:
ppublish
Résumé
Combination therapy, consisting of immune checkpoint inhibitors and traditional chemotherapeutic agents, has significantly improved the clinical outcomes of non-small cell lung cancer. Therefore, it will be a promising first-line therapy, whereas, there is a prospect that associated kidney injury may increase during treatment. We presented four patients, diagnosed with advanced non-small cell lung cancer, who received combination therapy, consisting of pembrolizumab, cisplatin, and pemetrexed as first-line treatment. All of them had been referred to nephrologists and had undergone renal biopsy. We observed that three of four patients presented a very rapid time course for acute kidney injury development. Notably, the three patients received only one or two cycles of the combined chemotherapy. In a renal biopsy, one patient showed severe acute tubular injury rather than interstitial nephritis. Another patient presented focal segmental glomerular sclerosis concomitant with tubulointerstitial nephritis. However, it was challenging to distinguish which agent was primarily responsible for kidney injury. Regarding the treatment, all the patients discontinued pembrolizumab and received corticosteroid treatment. We adjusted the dose and duration of corticosteroid according to the pathological results and patient conditions. The current cases provide a further understanding of clinical features and appropriate management in patients treated with combination therapy including pembrolizumab.
Identifiants
pubmed: 34406602
doi: 10.1007/s13730-021-00636-4
pii: 10.1007/s13730-021-00636-4
pmc: PMC8811082
doi:
Substances chimiques
Antibodies, Monoclonal, Humanized
0
pembrolizumab
DPT0O3T46P
Types de publication
Journal Article
Case Reports
Langues
eng
Sous-ensembles de citation
IM
Pagination
97-104Informations de copyright
© 2021. Japanese Society of Nephrology.
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