After nivolumab-ipilimumab for metastatic renal cancer, serum creatinine rises from 78 to 184 micromol/L. Dehydration, obstruction, sepsis and

Question

After nivolumab-ipilimumab for metastatic renal cancer, serum creatinine rises from 78 to 184 micromol/L. Dehydration, obstruction, sepsis and nephrotoxins have been excluded, and the rise is CTCAE grade 2. What management matches the UK nivolumab product information?

Accepted Answer

Withhold immunotherapy, start methylprednisolone-equivalent 0.5–1 mg/kg/day and reassess after recovery

Answer

Permanently discontinue immediately because every grade 2 creatinine rise precludes rechallenge

Answer

Continue both agents and repeat creatinine only at the next scheduled cycle

Answer

Reduce nivolumab by 50% and continue ipilimumab while starting oral fluids

Answer

Withhold corticosteroids until renal biopsy proves immune-mediated interstitial nephritis

RCC — SCE Medical Oncology MCQ

After nivolumab-ipilimumab for metastatic renal cancer, serum creatinine rises from 78 to 184 micromol/L. Dehydration, obstruction, sepsis and nephrotoxins have been excluded, and the rise is CTCAE grade 2. What management matches the UK nivolumab product information?