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Safety and efficacy of anti-PD-1 in patients with baseline cardiac, renal, or hepatic dysfunction

Overview of attention for article published in Journal for Immunotherapy of Cancer, October 2016
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  • Good Attention Score compared to outputs of the same age (69th percentile)
  • Average Attention Score compared to outputs of the same age and source

Mentioned by

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6 tweeters

Citations

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52 Dimensions

Readers on

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106 Mendeley
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Title
Safety and efficacy of anti-PD-1 in patients with baseline cardiac, renal, or hepatic dysfunction
Published in
Journal for Immunotherapy of Cancer, October 2016
DOI 10.1186/s40425-016-0166-5
Pubmed ID
Authors

Bridgette A. Kanz, Megan H. Pollack, Romany Johnpulle, Igor Puzanov, Leora Horn, Alicia Morgans, Jeffrey A. Sosman, Suthee Rapisuwon, R. Martin Conry, Zeynep Eroglu, Douglas B. Johnson

Abstract

Anti-PD-1 therapy is increasingly used in various advanced malignancies. Patients with baseline organ dysfunction are largely excluded from clinical trials. Therefore it is unclear whether anti-PD-1 therapy is safe or effective in this setting. Further, these patients are often not candidates for other anti-cancer therapies, highlighting their need for active treatment options. We performed a retrospective analysis of patients from multiple centers with advanced solid tumors and baseline organ dysfunction who received anti-PD-1 therapy. Organ dysfunction was defined as cardiac (left ventricular ejection fraction ≤45 %), renal (creatinine ≥2 mg/dL or GFR ≤30 ml/min) or hepatic dysfunction (evidence of cirrhosis on imaging or AST, ALT or bilirubin ≥3x ULN). We assessed change in organ dysfunction, immune related adverse events (irAEs), response rate, progression free survival (PFS) and overall survival (OS). We identified 27 patients eligible for inclusion with the following diseases: renal cell carcinoma (n = 8), melanoma (10), non-small cell lung cancer (3), small cell lung cancer (2) and urothelial bladder cancer (4). Baseline organ dysfunction included renal dysfunction (n = 17), hepatic dysfunction (7), cardiac dysfunction (11), including >1 organ dysfunction (8). Worsening organ dysfunction requiring hospitalization or dose delays occurred in 8 patients (30 %) although in most cases this was thought not-drug related and resolved with supportive care. Grade 3 irAEs occurred in 2 pts (7 %; hepatitis and colitis). Thirteen of 27 patients had ongoing treatment benefit (objective response or stable disease) at data collection (48 %). Eleven patients had primary progressive disease (41 %), 11 had stable disease (41 %), 4 had partial responses (15 %), and one had a complete response (4 %). Overall, median PFS was 168 days. Median OS was not reached. In our experience, anti-PD-1 agents in this group of patients with cardiac, hepatic or renal dysfunction were associated with tolerable irAEs and infrequent manageable worsening of organ dysfunction. Further, objective responses and prolonged PFS were observed in a number of patients. Thus, patients with baseline organ dysfunction may be considered for anti-PD-1 therapy with appropriate clinical monitoring.

Twitter Demographics

The data shown below were collected from the profiles of 6 tweeters who shared this research output. Click here to find out more about how the information was compiled.

Mendeley readers

The data shown below were compiled from readership statistics for 106 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 106 100%

Demographic breakdown

Readers by professional status Count As %
Researcher 22 21%
Other 17 16%
Student > Ph. D. Student 10 9%
Student > Bachelor 8 8%
Student > Postgraduate 6 6%
Other 20 19%
Unknown 23 22%
Readers by discipline Count As %
Medicine and Dentistry 50 47%
Agricultural and Biological Sciences 7 7%
Biochemistry, Genetics and Molecular Biology 5 5%
Pharmacology, Toxicology and Pharmaceutical Science 4 4%
Nursing and Health Professions 2 2%
Other 6 6%
Unknown 32 30%

Attention Score in Context

This research output has an Altmetric Attention Score of 5. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 14 April 2017.
All research outputs
#4,247,699
of 16,088,093 outputs
Outputs from Journal for Immunotherapy of Cancer
#628
of 1,369 outputs
Outputs of similar age
#88,954
of 295,099 outputs
Outputs of similar age from Journal for Immunotherapy of Cancer
#40
of 78 outputs
Altmetric has tracked 16,088,093 research outputs across all sources so far. This one has received more attention than most of these and is in the 73rd percentile.
So far Altmetric has tracked 1,369 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 14.5. This one has gotten more attention than average, scoring higher than 53% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 295,099 tracked outputs that were published within six weeks on either side of this one in any source. This one has gotten more attention than average, scoring higher than 69% of its contemporaries.
We're also able to compare this research output to 78 others from the same source and published within six weeks on either side of this one. This one is in the 48th percentile – i.e., 48% of its contemporaries scored the same or lower than it.