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TILs Melanoma — SCE Medical Oncology MCQ

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HardMelanoma & SkinTILs MelanomaSCE Medical Oncology

Pembrolizumab is withheld when creatinine rises to 3.4 times the upper limit of normal and immune-mediated nephritis is diagnosed. Which treatment-disposition statement is correct?

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Correct answer: C — Discontinue pembrolizumab permanently and start corticosteroid treatment

Creatinine above three times ULN is grade 3 or worse nephritis in the Keytruda SmPC and requires permanent discontinuation plus corticosteroid treatment. Temporary withholding applies to grade 2. Pembrolizumab has no validated dose-reduction scheme, and a fixed one-cycle pause ignores recovery and severity.

Reference: Keytruda UK SmPC. https://www.medicines.org.uk/emc/product/2498/smpc