Nephrotoxicity of Immune Checkpoint Inhibitors in Single and Combination Therapy-A Systematic and Critical Review.

IF 3.9 3区 工程技术 Q2 BIOCHEMISTRY & MOLECULAR BIOLOGY
Javier Tascón, Alfredo G Casanova, Laura Vicente-Vicente, Francisco J López-Hernández, Ana I Morales
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Abstract

Background/Objectives: Immune checkpoint inhibitors (ICIs) have generated a revolutionary approach in the treatment of cancer, but their effectiveness has been compromised by immune-related adverse events, including renal damage. Although rare, these effects are relevant because they have been related to poor patient prognoses. The objective of this review was to estimate the current incidence of nephrotoxicity in patients treated with single and double ICI therapies. Methods: A total of 1283 potential articles were identified, which were reduced to 50 after applying the exclusion and inclusion criteria. Results: This study reveals the increase in acute kidney injury associated with these drugs in the last decade and shows that, interestingly, combined therapies with ICIs does not lead to an increase in kidney damage compared with anti-CTLA-4. It also suggests that kidney damage could be underdiagnosed when it comes to interstitial nephritis, because definitive evidence requires a renal biopsy. Conclusions: In perspective, these conclusions could guide clinicians in making decisions for therapy personalization and highlight the need to search for new diagnostic systems that are more sensitive and specific to the type of damage and could replace the biopsy.

免疫检查点抑制剂在单一和联合治疗中的肾毒性——一个系统和关键的综述。
背景/目的:免疫检查点抑制剂(ici)在癌症治疗中产生了一种革命性的方法,但其有效性受到免疫相关不良事件(包括肾损害)的影响。虽然罕见,但这些影响是相关的,因为它们与患者预后不良有关。本综述的目的是估计目前接受单次和双次ICI治疗的患者肾毒性的发生率。方法:共筛选出1283篇潜在文献,经排除纳入标准后减至50篇。结果:这项研究揭示了在过去十年中与这些药物相关的急性肾损伤的增加,并且有趣的是,与抗ctla -4相比,与ICIs联合治疗不会导致肾损伤的增加。它还表明,当涉及到间质性肾炎时,肾脏损害可能被误诊,因为明确的证据需要肾活检。结论:从这个角度来看,这些结论可以指导临床医生做出个性化治疗的决定,并强调需要寻找对损伤类型更敏感和特异性的新诊断系统,并可以取代活检。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Biomedicines
Biomedicines Biochemistry, Genetics and Molecular Biology-General Biochemistry,Genetics and Molecular Biology
CiteScore
5.20
自引率
8.50%
发文量
2823
审稿时长
8 weeks
期刊介绍: Biomedicines (ISSN 2227-9059; CODEN: BIOMID) is an international, scientific, open access journal on biomedicines published quarterly online by MDPI.
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