What is your approach to re-challenging patients with immune checkpoint inhibitors whom developed predominately acute tubular injury without acute interstitial nephritis?
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How do you approach rechallenge with an immune checkpoint inhibitor in a patient whose kidney function has recovered after biopsy-proven acute tubular injury without interstitial nephritis?
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1 Answer
Mednet MemberInvited Expert
Nephrology · University of California, Los Angeles
Answered on
In patients with immune checkpoint inhibitor (ICI)-associated acute interstitial nephritis (AIN) whose renal function has recovered, most do not develop recurrent ICI-associated AIN after rechallenge. However, data on the recurrence of acute tubular injury (ATI) specifically after ICI rechallenge are limited. Importantly, other etiologies of ATI should be excluded and treated accordingly. If the anticipated oncologic benefit justifies the risk, rechallenge may be considered after substantial recovery of kidney function, with close monitoring of renal function.