Journal for ImmunoTherapy of Cancer (Sep 2022)
Shorter versus longer corticosteroid duration and recurrent immune checkpoint inhibitor-associated AKI
- Joe-Elie Salem,
- Enriqueta Felip,
- Shuchi Anand,
- Karolina Benesova,
- Marlies Ostermann,
- Ala Abudayyeh,
- Omar Mamlouk,
- Umut Selamet,
- Grace Cherry,
- Sunandana Chandra,
- Sandra M Herrmann,
- Maria Jose Soler,
- Abhijat Kitchlu,
- Jamie S Lin,
- Kerry L Reynolds,
- Elizabeth M Gaughan,
- Eva Muñoz-Couselo,
- Jamie S Hirsch,
- Pablo Garcia,
- Meghan E Sise,
- Thibaud Koessler,
- Mark Eijgelsheim,
- Shruti Gupta,
- Frank B Cortazar,
- Jason M Prosek,
- Ilya Glezerman,
- Shveta S Motwani,
- Naoka Murakami,
- Rimda Wanchoo,
- David I Ortiz-Melo,
- Arash Rashidi,
- Ben Sprangers,
- Vikram Aggarwal,
- A Bilal Malik,
- Sebastian Loew,
- Christopher A Carlos,
- Pazit Beckerman,
- Zain Mithani,
- Chintan V Shah,
- Amanda D Renaghan,
- Sophie De Seigneux,
- Luca Campedel,
- Daniel Sanghoon Shin,
- Sunil Rangarajan,
- Priya Deshpande,
- Gaia Coppock,
- Marium Husain,
- Clara Garcia-Carro,
- Sheila Bermejo,
- Nuttha Lumlertgul,
- Nina Seylanova,
- Busra Isik,
- Aydin Kaghazchi,
- Yuriy Khanin,
- Sheru K Kansal,
- Kai M Schmidt-Ott,
- Raymond K Hsu,
- Maria C Tio,
- Harkarandeep Singh,
- Kenar D Jhaveri,
- David E Leaf,
- Corinne Isnard Bagnis,
- Suraj S Mothi,
- Weiting Chang,
- Vipulbhai Sakhiya,
- Daniel Stalbow,
- Sylvia Wu,
- Armando Cennamo,
- Anne Rigg,
- Nisha Shaunak,
- Zoe A Kibbelaar,
- Harish S Seethapathy,
- Meghan Lee,
- Ian A Strohbhen,
- Ilya G Glezerman,
- Dwight H Owen,
- Sharon Mini,
- Andrey Kisel,
- Nicole Albert,
- Katherine Carter,
- Vicki Donley,
- Tricia Young,
- Heather Cigoi,
- Els Wauters Ben Sprangers,
- Javier A Pagan,
- Jonathan J Hogan,
- Valda Page,
- Samuel AP Short,
- A Bilal Malik,
- Maria Josep Carreras,
- Sethu M. Madhavan
Affiliations
- Joe-Elie Salem
- Cardio-Oncology Program, Pitié-Salpétrière Hospital, Paris, France, AP-HP, Pitié-Salpétrière Hospital,Sorbonne, INSERM, CIC-1901, Paris, France, Paris, France, France
- Enriqueta Felip
- Medical Oncology Service, Vall d’Hebron University Hospital, Vall d’Hebron Institute of Oncology, Barcelona, Spain
- Shuchi Anand
- Division of Nephrology, Stanford University School of Medicine, Palo Alto, California, USA
- Karolina Benesova
- University Hospital Heidelberg, Department of Medicine V, Division of Rheumatology, Heidelberg, Germany
- Marlies Ostermann
- Department of Critical Care & Nephrology, King’s College London, Guy’s and St Thomas’ Hospital, London, UK
- Ala Abudayyeh
- professor
- Omar Mamlouk
- Divison of Internal Medicine, Section of Nephrology, University of Texas MD Anderson Cancer Center, Houston, Texas, USA
- Umut Selamet
- Grace Cherry
- Sunandana Chandra
- Robert H. Lurie Comprehensive Cancer Center, Northwestern University, Chicago, Illinois, USA
- Sandra M Herrmann
- Division of Nephrology & Hypertension, Mayo Clinic, Rochester, Minnesota, USA
- Maria Jose Soler
- Nephrology Department, Vall d’Hebron University Hospital, Vall d`Hebron Institute of Research, Barcelona, Spain
- Abhijat Kitchlu
- Division of Nephrology, University Health Network, University of Toronto, Toronto, Ontario, Canada
- Jamie S Lin
- Divison of Internal Medicine, Section of Nephrology, University of Texas MD Anderson Cancer Center, Houston, Texas, USA
- Kerry L Reynolds
- assistant professor
- Elizabeth M Gaughan
- 4 Department of Medicine, Division of Hematology/Oncology University of Virginia, Charlottesville, Virginia, USA
- Eva Muñoz-Couselo
- Hospital Universitario Vall d`Hebron, Passeig de la Vall d`Hebron, Vall d’Hebron Institute of Oncology (VHIO), Barcelona, Spain
- Jamie S Hirsch
- associate professor
- Pablo Garcia
- Division of Nephrology, Stanford University School of Medicine, Palo Alto, California, USA
- Meghan E Sise
- associate professor
- Thibaud Koessler
- Mark Eijgelsheim
- Department of Internal Medicine, Division of Nephrology, University Medical Center Groningen, University of Groningen, Gronigen, The Netherlands
- Shruti Gupta
- assistant professor
- Frank B Cortazar
- New York Nephrology Vasculitis and Glomerular Center, Albany, New York, USA
- Jason M Prosek
- Division of Nephrology, Department of Internal Medicine, The Ohio State University Medical Center, Columbus, Ohio, USA
- Ilya Glezerman
- Renal Service, Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York, New York, USA
- Shveta S Motwani
- assistant professor
- Naoka Murakami
- Division of Renal Medicine, Brigham and Women’s Hospital, Boston, Massachusetts, USA
- Rimda Wanchoo
- Division of Kidney Diseases and Hypertension, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Northwell Health, Hempstead, New York, USA
- David I Ortiz-Melo
- Division of Nephrology, Duke University School of Medicine, Durham, North Carolina, USA
- Arash Rashidi
- Division of Nephrology and Hypertension, University Hospital Cleveland Medical Center, Cleveland, Ohio, USA
- Ben Sprangers
- Department of Microbiology, Immunology and Transplantation, Laboratory of Molecular Immunology (Rega Institute for Medical Research), KU Leuven, Leuven, Belgium
- Vikram Aggarwal
- Department of Nephrology and Hypertension, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
- A Bilal Malik
- Division of Nephrology, University of Washington, Seattle, Washington, USA
- Sebastian Loew
- Department of Nephrology and Medical Intensive Care, Charité – Universitätsmedizin Berlin, Berlin, Germany
- Christopher A Carlos
- Division of Nephrology, Department of Medicine, University of California San Francisco, San Francisco, California, USA
- Pazit Beckerman
- Institute of Nephrology and Hypertension, Sheba Medical Center and Sackler School of Medicine, Tel Aviv University, Tel Hashomer, Tel Aviv, Israel
- Zain Mithani
- Katz Family Division of Nephrology and Hypertension, Department of Medicine, University of Miami Miller School of Medicine, Miami, Florida, USA
- Chintan V Shah
- Division of Nephrology, Hypertension, and Renal Transplant, Department of Medicine, University of Florida, Gainesville, Florida, USA
- Amanda D Renaghan
- Division of Nephrology, University of Virginia Health System, Charlottesville, Virginia, USA
- Sophie De Seigneux
- Service of Nephrology, Department of Medicine, University Hospital of Geneva, Geneva, Switzerland
- Luca Campedel
- Department of Medical Oncology, Assistance Publique - Hopitaux de Paris, Paris, France
- Daniel Sanghoon Shin
- Division of Hematology-Oncology, VAGLAHS, Department of Medicine, David Geffen School of Medicine at University of California-Los Angeles, Los Angeles, California, USA
- Sunil Rangarajan
- Division of Hematology/Oncology and Division of Nephrology, The University of Alabama School of Medicine, Birmingham, Alabama, USA
- Priya Deshpande
- Division of Nephrology, Department of Medicine, Icahn School of Medicine at the Mount Sinai Hospital, New York, New York, USA
- Gaia Coppock
- Renal-Electrolyte and Hypertension Division, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
- Marium Husain
- Division of Medical Oncology, Department of Internal Medicine, The Ohio State University, Columbus, Ohio, USA
- Clara Garcia-Carro
- Nephrology Department, Vall d’Hebron University Hospital, Vall d`Hebron Institute of Research, Barcelona, Spain
- Sheila Bermejo
- Nephrology Department, Vall d’Hebron University Hospital, Vall d`Hebron Institute of Research, Barcelona, Spain
- Nuttha Lumlertgul
- Department of Critical Care & Nephrology, Guy’s and St Thomas Hospital, London, UK
- Nina Seylanova
- 1I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russian Federation
- Busra Isik
- Division of Nephrology & Hypertension, Mayo Clinic, Rochester, Minnesota, USA
- Aydin Kaghazchi
- Division of Epidemiology and Population Health, Stanford University, Palo Alto, California, USA
- Yuriy Khanin
- Division of Kidney Diseases and Hypertension, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Northwell Health, Hempstead, New York, USA
- Sheru K Kansal
- Division of Nephrology and Hypertension, University Hospital Cleveland Medical Center, Cleveland, Ohio, USA
- Kai M Schmidt-Ott
- Department of Nephrology and Medical Intensive Care, Charité – Universitätsmedizin Berlin, Berlin, Germany
- Raymond K Hsu
- Division of Nephrology, Department of Medicine, University of California San Francisco, San Francisco, California, USA
- Maria C Tio
- Division of Renal Medicine, Brigham and Women’s Hospital, Boston, Massachusetts, USA
- Harkarandeep Singh
- Division of Renal Medicine, Brigham and Women’s Hospital, Boston, Massachusetts, USA
- Kenar D Jhaveri
- professor
- David E Leaf
- associate professor
- Corinne Isnard Bagnis
- Suraj S Mothi
- Weiting Chang
- Vipulbhai Sakhiya
- Daniel Stalbow
- Sylvia Wu
- Armando Cennamo
- Anne Rigg
- Nisha Shaunak
- Zoe A Kibbelaar
- Harish S Seethapathy
- Meghan Lee
- Ian A Strohbhen
- Ilya G Glezerman
- associate professor
- Dwight H Owen
- Sharon Mini
- Andrey Kisel
- Nicole Albert
- Katherine Carter
- Vicki Donley
- Tricia Young
- Heather Cigoi
- Els Wauters Ben Sprangers
- Javier A Pagan
- Jonathan J Hogan
- Valda Page
- Samuel AP Short
- A Bilal Malik
- Maria Josep Carreras
- Sethu M. Madhavan
- DOI
- https://doi.org/10.1136/jitc-2022-005646
- Journal volume & issue
-
Vol. 10,
no. 9
Abstract
Background Corticosteroids are the mainstay of treatment for immune checkpoint inhibitor-associated acute kidney injury (ICPi-AKI), but the optimal duration of therapy has not been established. Prolonged use of corticosteroids can cause numerous adverse effects and may decrease progression-free survival among patients treated with ICPis. We sought to determine whether a shorter duration of corticosteroids was equally efficacious and safe as compared with a longer duration.Methods We used data from an international multicenter cohort study of patients diagnosed with ICPi-AKI from 29 centers across nine countries. We examined whether a shorter duration of corticosteroids (28 days or less) was associated with a higher rate of recurrent ICPi-AKI or death within 30 days following completion of corticosteroid treatment as compared with a longer duration (29–84 days).Results Of 165 patients treated with corticosteroids, 56 (34%) received a shorter duration of treatment and 109 (66%) received a longer duration. Patients in the shorter versus longer duration groups were similar with respect to baseline and ICPi-AKI characteristics. Five of 56 patients (8.9%) in the shorter duration group and 12 of 109 (11%) in the longer duration group developed recurrent ICPi-AKI or died (p=0.90). Nadir serum creatinine in the first 14, 28, and 90 days following completion of corticosteroid treatment was similar between groups (p=0.40, p=0.56, and p=0.89, respectively).Conclusion A shorter duration of corticosteroids (28 days or less) may be safe for patients with ICPi-AKI. However, the findings may be susceptible to unmeasured confounding and further research from randomized clinical trials is needed.
