MO362CHECK- POINT INHIBITORS AND THEIR KIDNEY INVOLVEMENT

Abstract

Abstract Background and Aims Monotherapy immunotherapy with “check-point inhibitors” (anti PD-1, Anti PD-L1) is an effective therapy to advanced-stage cancer patients. Little is known about our experience and its renal implication, although it is related to fluid and electrolyte disorders or acute kidney failure (AKI). To evaluate changes in natremia or acute renal impairment (primary endpoints) in IV stage cancer patients with lung, bladder or melanoma neoplasm who have received monotherapy with pembrolizumab (PEM), atezolizumab (ATZ) or nivolumab (NIV). At the same time, analyze if there are differences between drug administered, underlying disease or having received cisplatin previously (secondary outcomes). Method single-center retrospective analysis. Inclusion period: January 2015 to September 2020. Dose administered: PEM 2mcg/kg/21 days; ATZ 1200mg/21 days; NIV 3mg/kg/ 21 days. Changes in natremia and GFR (CDK-EPI) were evaluated in 0,1,3 months of follow-up. Patients with combined chemotherapy were excluded. Results 137 patients were included. Mean age: 64 years. Men: 71.6%. Neoplasm: lung (76.8%), bladder (7.2%), melanoma (15.9%). Patients received 27.5% PEM; 26.1% ATZ; 46.4% NIV. Between all of them, 76% had received platinum previously. Up to 13.6% developed hyponatremia and 12.40% AKI 3 months later. The decrease in GFR was significantly greater in bladder neoplasm (mean GFR 42ml / min / m2 p <0.01) at three months. Bladder cancer was also the most frequent (but not significant) in reduced natremia (mean Na 135mEq / L p = 0.08). There were no differences according to drug administration or having received platinum previously. 61% were death, but none of them due to a renal event. Conclusion