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Adverse Renal Effects of Immune Checkpoint Inhibitors: A Narrative Review

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Wanchoo, Rimda, Karam, Sabine, Uppal, Nupur N., Barta, Valerie S., Deray, Gilbert, Devoe, Craig, Launay-Vacher, Vincent, Jhaveri, Kenar D., on behalf of Cancer and Kidney International Network Workgroup on Immune Checkpoint Inhibitors·2017·American Journal of Nephrology

DOI 10.1159/000455014

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Abstract

Background: Cancer immunotherapy, such as anti-cytotoxic T-lymphocyte-associated protein 4 (CTLA-4) and anti-programmed death 1 (PD-1), has revolutionized the treatment of malignancies by engaging the patient's own immune system against the tumor rather than targeting the cancer directly. These therapies have demonstrated a significant benefit in the treatment of melanomas and other cancers. Summary: In order to provide an extensive overview of the renal toxicities induced by these agents, a Medline search was conducted of published literature related to ipilimumab-, pembrolizumab-, and nivolumab-induced kidney toxicity. In addition, primary data from the initial clinical trials of these agents and the FDA adverse reporting system database were also reviewed to determine renal adverse events. Acute interstitial nephritis (AIN), podocytopathy, and hyponatremia were toxicities caused by ipilimumab. The main adverse effect associated with both the PD-1 inhibitors was AIN. The onset of kidney injury seen with PD-1 inhibitors is usually late (3-10 months) compared to CTLA-4 antagonists related renal injury, which happens earlier (2-3 months). PD-1 as opposed to CTLA-4 inhibitors has been associated with kidney rejection in transplantation. Steroids appear to be effective in treating the immune-related adverse effects noted with these agents. Key Message: Although initially thought to be rare, the incidence rates of renal toxicities might be higher (9.9-29%) as identified by recent studies. As a result, obtaining knowledge about renal toxicities of immune checkpoint inhibitors is extremely important.

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Authors: Wanchoo, R., Karam, S., Uppal, N. N., Barta, V. S., Deray, G., Devoe, C., Launay-Vacher, V., Jhaveri, K. D., & on behalf of Cancer and Kidney International Network Workgroup on Immune Checkpoint Inhibitors
Venue: American Journal of Nephrology
Publisher: S. Karger AG
Published: 2017
Volume: 45
Issue: 2
Pages: 160-169
ISSN: 0250-8095 (ISSN-L)
1421-9670
DOI: 10.1159/000455014
OpenAlex: W2572174216
Cited by: 15,256
References: 14
FWCI: 180.98
Type: journal article
Language: en
Open access: bronze
Licence: www.karger.com/Services/SiteLicenses (vor)
www.karger.com/Services/SiteLicenses (tdm)

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Adverse Renal Effects of Immune Checkpoint Inhibitors: A Narrative Review

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