Nivolumab Efficacy and Safety in Cancer Patients with Renal Dysfunction

Abstract

Aim: Immune checkpoint inhibitors have transformed cancer treatment; however, clinical trials often exclude patients with renal dysfunction. This study aimed to evaluate the efficacy and safety of nivolumab in this population, addressing the limited available data. Methods: A retrospective cross-sectional study was conducted on patients with baseline renal dysfunction who received nivolumab between 2018 and 2023. The safety and efficacy endpoints, including immune-related adverse events (irAEs), treatment response, and progression-free survival. Results: Fifty patients with various malignancies were included, with 30% experiencing manageable worsening of renal function. Approximately 51% of patients experienced no irAEs, whereas 8% experienced grade 3 or 4 adverse events. The treatment discontinuation rate due to adverse effects was 2%. Significantly, 68% of patients showed treatment benefits, with a median progression-free survival of 450 days. Conclusion: Nivolumab is effective and safe for patients with renal dysfunction, with comparable outcomes to those without renal impairment. Despite the occurrence of IrAEs, they were manageable, and we observed benefits in long-term progression-free survival.

Keywords

• nivolumab
• immune checkpoint inhibitors
• kidney diseases
• drug-related side effects and adverse reactions
• progression-free survival