According to the drug insert, there are no data on treatment with PD-1/PD-L1 inhibitors in pregnant women, but in animal studies, PD-1/PD-L1 inhibitors can cause fetal damage with increased rates of miscarriage and stillbirth, and therefore are not recommended. For women who are breastfeeding, it is recommended that breastfeeding be suspended while the drug is administered.
It is not clear at what age children can use PD-1/PD-L1 inhibitors. People over the age of 65 are more likely to have accelerated tumor progression (Hyper Progressive Disease (HPD), also known as tumor burst progression), where the tumor grows more than twice as fast as it did before treatment and increases in size by more than 50%. Therefore, this group of patients should be cautious with PD-1/PD-L1 inhibitors.
Patients with mild hepatic or renal impairment can use PD-1/PD-L1 inhibitors as usual, but there are no data on the use of PD-1/PD-L1 inhibitors in patients with moderate to severe hepatic or renal impairment.
Patients who have had prior HSCT (allogeneic hematopoietic stem cell transplantation) are at significantly higher risk of developing severe graft-versus-host disease (GVHD) after treatment with PD-1/PD-L1 inhibitors and require special attention when dosing. In addition, PD-1/PD-L1 inhibitors are not recommended in the presence of immune system disorders (e.g., Crohn’s disease, ulcerative colitis, lupus erythematosus, etc.), if you test positive for HIV, or if you have AIDS.
Co-reviewed by: Guangdong Provincial People’s Hospital Guangdong Lung Cancer Institute Dr. Wang Zhen, Deputy Chief Physician Peng Xiaoxiao