How do you manage maintenance therapy in metastatic NSCLC, adenocarcinoma with good response to initial chemo (carboplatin, pemetrexed, pembrolizumab) with borderline renal function that has worsened during initial treatment?

Would you stop all treatment after 4 cycles, or proceed with pembrolizumab alone, and would PD-L1 expression factor into your decision?

Community PollStarted

For patients who develop worsening renal function during carboplatin, pemetrexed, pembrolizumab, after 4 cycles would you:

37 physicians have voted

Join Mednetto vote and see how they answered.

2 Answers

Mednet Member

Medical Oncology · Boston Med Center

Answered on

This is a difficult situation as it may not be possible to discern if creatinine elevation is related to pemetrexed versus immune checkpoint inhibitor (ICI)-nephritis; therefore, nephrology assessment would be crucial.

I assume the question is regarding patients with significant renal impairment (i.e...

Join for free or sign in to see the full answer

Mednet MemberInvited Expert

Medical Oncology · Albert Einstein College of Medicine at Montefiore Medical Center

Answered on

I very much agree with Dr. @Dr. First Last's answer here.

This is a common and vexing problem for the clinician- when facing renal toxicity- a real concern with short and long-term health consequences but in a setting that our patient also needs life-prolonging systemic therapy. Which drug to ...

Join for free or sign in to see the full answer