{"doi":"10.1002/cam4.71058","title":"Early Acute Kidney Injury and Its Association With Survival in Patients With Metastatic Non‐Small‐Cell Lung Cancer Treated With Front‐Line Immunotherapy‐Based Therapies","abstract":"INTRODUCTION: Immune checkpoint inhibitors (ICIs) have revolutionized metastatic NSCLC treatment. Acute kidney injury (AKI) is a common complication of ICI-based therapies, alone or with chemotherapy. This study investigates the association between early AKI and 12-month survival among patients with metastatic NSCLC receiving front-line ICI-based treatment. METHODS: This retrospective study included metastatic NSCLC patients who received ICI-based therapy (2017-2022). Early AKI was defined as a creatinine increase ≥ 1.5 times baseline within 21 days of the fourth cycle or last cycle if fewer than four were given. Clinical characteristics were compared using t-tests and chi-squared tests. Survival differences were assessed by Kaplan-Meier and log-rank tests, with Cox models evaluating the association between AKI and 12-month survival. RESULTS: Of the 310 patients, AKI occurred in 38 patients (12.6%), with 8 patients (2.3%) missing follow-up creatinine data. The hazard ratio (HR) for death within 12 months for patients who developed early AKI was 1.733 (95% CI 1.060-2.835, p = 0.026). The highest rate of early AKI was seen in patients receiving pemetrexed, pembrolizumab, and carboplatin (16.7%), compared to 11.1% for pembrolizumab monotherapy and 4.5% for pembrolizumab with paclitaxel and carboplatin. Although patients who recovered renal function were more likely to continue immunotherapy, 12-month survival rates did not significantly differ (52.2% vs. 46.7%). CONCLUSIONS: Early AKI during pembrolizumab-based treatment in metastatic NSCLC patients was associated with reduced 12-month survival. These findings highlight the need for close monitoring and preventive strategies to manage AKI in this population.","journal":"Cancer Medicine","year":2025,"id":571077,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":0,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9643,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2025-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":1419248,"name":"Po‐Lan Su","orcid":"0000-0002-8470-6590","position":1,"is_corresponding":false},{"id":338045,"name":"Songzhu Zhao","orcid":null,"position":2,"is_corresponding":false},{"id":953351,"name":"Grace Cheng","orcid":"0000-0001-8835-2067","position":3,"is_corresponding":false},{"id":1026636,"name":"Nicholas Jones","orcid":"0000-0003-4846-5117","position":4,"is_corresponding":false},{"id":1187300,"name":"Kenneth Chian","orcid":null,"position":5,"is_corresponding":false},{"id":1255341,"name":"Natalie Johns","orcid":null,"position":6,"is_corresponding":false},{"id":886705,"name":"Adam Khorasanchi","orcid":"0000-0002-4603-376X","position":7,"is_corresponding":false},{"id":713949,"name":"Adeoluwa A. 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