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

Figures & data

Table 1. Baseline characteristics of patients.

	ESRD	Non-ESRD	p Value
Total, n	777	777
Age at ICI (mean, SD), yrs	67.8 (10.8)	68.0 (10.3)	0.71
Sex, n (%)			0.87
Male	553 (71.2)	551 (70.9)
Female	224 (28.8)	226 (29.1)
Race, n (%)			0.29
White	538 (69.2)	543 (69.9)
Black	139 (17.9)	146 (18.8)
Asian	40 (5.1)	30 (3.9)
ECOG PS, n (%)			0.88
Total available patients	148	78
0–2	133 (89.9)	73 (93.6)
3–4	15 (10.1)	5 (6.4)
Autoimmune disease, n (%)	35 (4.5)	30 (3.9)	0.40
Dialysis types, n (%)		N/A	N/A
Hemodialysis	737 (94.9)
Peritoneal dialysis	40 (5.1)
ICI, n (%)			0.52
Pembrolizumab	381 (49.0)	390 (50.2)
Nivolumab	411 (52.9)	398 (51.2)
Ipilimumab + nivolumab	126 (16.2)	115 (14.8)
RCC, n	304	304
eGFR, mean (SD)	N/A	63.8 (28.4)
ICI, n (%)			0.36
Pembrolizumab	74 (24.3)	81 (26.6)
Nivolumab	227 (74.7)	225 (74.0)
Ipilimumab + nivolumab	87 (28.6)	80 (26.3)
Prior TKI, n (%)
Sunitinib	42 (13.8)	39 (12.8)	0.61
Axitinib	46 (15.1)	43 (14.1)	0.62
Pazopanib	54 (17.8)	51 (16.8)	0.65
Cabozantinib	43 (14.1)	33 (10.9)	0.07
Lung cancer, n	190	190
ICI, n (%)			0.88
Pembrolizumab	114 (60.0)	115 (60.5)
Nivolumab	76 (40.0)	75 (39.5)
Ipilimumab + nivolumab	12 (6.3)	10 (5.3)
Regimens, n (%)			1.0
ICI + chemotherapy	78 (41.1)	78 (41.1)
ICI alone	112 (58.9)	112 (58.9)
Prior osimertinib, n (%)	10 (5.3)	10 (5.3)	1.0
Melanoma, n	130	130
ICI, n (%)			0.73
Pembrolizumab	73 (56.2)	71 (54.6)
Nivolumab	62 (47.7)	62 (47.7)
Ipilimumab + nivolumab	27 (20.8)	25 (19.2)
Prior BRAFi/MEKi, n (%)
Dabrafenib/trametinib	10 (7.7)	10 (7.7)	1.00
Vemurafenib/binimetinib	10 (7.7)	0	N/A
Encorafenib/cobimetinib	10 (7.7)	0	N/A
Bladder cancer, n	124	124
ICI, n (%)			0.65
Pembrolizumab	99 (79.8)	101 (81.5)
Nivolumab	26 (21.0)	23 (18.5)
Ipilimumab + nivolumab	0 (0)	0 (0)
Prior therapies, n (%)
Cisplatin	26 (21.0)	23 (18.5)	0.49
Avelumab	0 (0)	0 (0)	N/A
Atezolizumab	0 (0)	0 (0)	N/A
Head and neck cancer, n	29	29
ICI, n (%)			1.0
Pembrolizumab	21 (72.4)	22 (75.9)
Nivolumab	10 (34.5)	10 (34.5)
Ipilimumab + nivolumab	0 (0)	0 (0)
Regimens, n (%)			1.0
ICI + chemotherapy	10 (34.5)	10 (34.5)
ICI alone	19 (65.5)	19 (65.5)
Prior cisplatin, n (%)	10 (34.5)	10 (34.5)	1.0

BRAFi/MEKi: BRAF and MEK inhibitors; eGFR: estimated glomerular filtration rate, per mL/min/1.73m²; ESRD: end-stage renal disease; ICI: immune checkpoint inhibitor; PS: performance status; RCC: renal cell carcinoma; SD: standard deviation; TKI: tyrosine kinase inhibitor.

Figure 1. Cumulative incidence of irAEs in patients with and without ESRD. For patients with various types of cancer, there was no significant difference in cumulative incidence regarding all irAE (A), skin toxicity (B), thyroid toxicity (C), colitis (D), pneumonitis (E), or hepatitis (F).

Data availability statement

Data available on request from the authors.