Penpulimab Disease Interactions

Fatal and other serious complications can occur in patients who receive allogeneic hematopoietic stem cell transplantation (HSCT) before or after being treated with a programmed death receptor-1/ligand-1 (PD-1/PD-L1) blocking antibody. Transplant-related complications include hyperacute graft-versus-host disease (GVHD), acute GVHD, chronic GVHD, hepatic veno-occlusive disease after reduced intensity conditioning, and steroid-requiring febrile syndrome (without an identified infectious cause). These complications may occur despite intervening therapy between PD-1/PD-L1 blockade and allogeneic HSCT. It is recommended to follow patients closely for evidence of transplant-related complications and intervene promptly. The benefit versus risks of treatment with a PD-1/PD-L1 blocking antibody before or after an allogeneic HSCT should be considered.

Solid organ transplant rejection and other transplant (including corneal graft) rejection have been reported with the use of programmed death receptor-1/ligand-1 (PD-1/PD-L1) blocking antibodies. Care should be exercised when using PD-1/PD-L1 blocking antibodies in patients who have received a solid organ or other transplant.

The effect of severe hepatic dysfunction (total bilirubin greater than 3 times ULN and any AST) on the pharmacokinetics of penpulimab is unknown. Additionally, this drug can cause immune-mediated hepatitis and hepatotoxicity. Evaluate liver enzymes at baseline and periodically during treatment.

Penpulimab can cause immune-mediated pneumonitis. In general, the incidence of pneumonitis was higher in patients with prior thoracic radiation.

The effect of severe renal dysfunction (CrCl below 30 mL/min) on the pharmacokinetics of penpulimab is unknown. Additionally, this drug can cause immune-mediated nephritis and renal dysfunction. Patients should be monitored for early identification and management. Evaluate creatinine levels at baseline and periodically during treatment.