Comorbidities remain common in patients diagnosed with cancer and can impact both treatment options and outcomes. In particular, there is evidence that renal or hepatic dysfunction may impact treatment choices due to concerns over decreased drug clearance and increased toxicity. Additionally, patients with evidence of renal or hepatic dysfunction have been historically excluded from most clinical trials. Given the high efficacy of immune checkpoint inhibitors (ICIs) and the limited treatment options available in advanced melanoma, the role of ICIs in patients with baseline renal and hepatic dysfunction is highly relevant, and additional information is needed.
Researchers from the National Cancer Institute and Flatiron Health used real-world data to examine treatment patterns, toxicity and clinical outcomes of patients with advanced melanoma and organ dysfunction treated with immune checkpoint inhibitors.
Why this matters
For clinicians, managing patients with organ dysfunction represents a conundrum, since restrictions in clinical trial eligibility often leave a data gap regarding these patients. This study provides useful real-world information to address that gap. Along the way, by better understanding the impact (or lack thereof) of organ dysfunction on novel treatments’ effectiveness and/or safety, we are paving the way to more inclusive clinical trial protocols.