How would you treat a patient with active lupus nephritis (class 3/4) who requires PD-1 immunotherapy for refractory metastatic renal cell carcinoma?

This is a complex question and there is a paucity of data to address it. The critical issues are of timing (new onset or existing nephritis, disease activity) and treatment regimen.

Given that oncologists will not use checkpoint inhibitors on patients requiring more than 10 mg of prednisone at base...

Agree with above, a very complex question! I would strongly suggest glucocorticosteroids 60mg for 1 week, then 40mg for 1 week then 30mg for 1 week then 20mg for 1 week then 15mg for 1 week and decrease by 1mg a month, I would recommend adding benlysta and possible Cellcept together. I would make su...