Prediction of Immune Checkpoint Inhibitors-Associated Renal Damage in Oncology Patients
Abstract
In recent decades, immune checkpoint inhibitors (ICIs) have revolutionized cancer treatment, although their efficacy is affected by adverse effects such as nephrotoxicity, negatively impacting prognosis. Our hypothesis suggests that ICIs could produce subclinical renal damage, not evidenced by usual clinical tests. The aim of this work was to study the application of urinary biomarkers in the early diagnosis of renal damage associated with ICIs. A prospective study was carried out in which patients treated with ICIs or with combined ICIs/chemotherapy were enrolled. Patients were followed for 12 treatment cycles and urine samples were collected before starting treatment, as well as before and after the third cycle. Patients were classified into “cases” (if during treatment they developed renal damage, according to KDIGO criteria and/or electrolyte alterations compatible with treatment with ICIs appeared) and “controls” (patients without renal damage during the study). Biomarkers A, B, C, D and E were determined by ELISA. Our results showed a significant excretion of A and B before receiving the third cycle in cases compared to controls. In addition, a trend of increased excretion of C and D was observed, even before receiving therapy. Therefore, these biomarkers could predict the renal damage produced by ICIs allowing a preventive and personalized management of the patient.- Referencias
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Alonso F, Martín de Francisco ÁLM, Auñón P, García-Carro C, García P, Gutiérrez E, et al. Efectos renales adversos por inhibidores del check-point (ICP) en pacientes con cáncer. Recomendaciones del grupo de Onconefrología de la Sociedad Española de Nefrología (SEN). Nefrología. 2023;43(5):622-35.
Bagchi S, Yuan R, Engleman EG. Immune Checkpoint Inhibitors for the Treatment of Cancer: Clinical Impact and Mechanisms of Response and Resistance. Annu Rev Pathol Mech Dis. 2021;16(1): 223-49.
De Francisco ALM, Macía M, Alonso F, García P, Gutierrez E, Quintana LF, et al. Onco-Nefrología: cáncer, quimioterapia y riñón. Nefrología. 2019;39(5):473-81.
Francis DM, Thomas SN. Progress and opportunities for enhancing the delivery and efficacy of checkpoint inhibitors for cancer immunotherapy. Adv Drug Deliv Rev 2017;114:33-42.
He X, Xu C. Immune checkpoint signaling and cancer immunotherapy. Cell Res. 2020;30(8):660-9.
Herrmann SM, Perazella MA. Immune Checkpoint Inhibitors and Immune-Related Adverse Renal Events. Kidney Int Rep. 2020;5(8):1139-48.
Miao J, Sise ME, Herrmann SM. Immune checkpoint inhibitor related nephrotoxicity: Advances in clinicopathologic features, noninvasive approaches, and therapeutic strategy and rechallenge. Front Nephrol. 2022;2.
Poto R, Troiani T, Criscuolo G, Marone G, Ciardiello F, Tocchetti CG, et al. Holistic Approach to Immune Checkpoint Inhibitor-Related Adverse Events. Front Immunol. 2022;13.
Rao Ullur A, Côté G, Pelletier K, Kitchlu A. Immunotherapy in oncology and the kidneys: a clinical review of the evaluation and management of kidney immune-related adverse events. Clin Kidney J. 2023;16(6):939-51.
Seidel JA, Otsuka A, Kabashima K. Anti-PD-1 and Anti-CTLA-4 Therapies in Cancer: Mechanisms of Action, Efficacy, and Limitations. Front Oncol. 2018;8:86.
Seijas M, Baccino C, Nin N, Lorente JA. Definición y biomarcadores de daño renal agudo: nuevas perspectivas. Med Intensiva. 2014;38(6):376-85.
Shingarev R, Glezerman IG. Kidney Complications of Immune Checkpoint Inhibitors: A Review. Am J Kidney Dis. 2019;74(4):529-37.
Tinawi M, Bastani B. Nephrotoxicity of Immune Checkpoint Inhibitors: Acute Kidney Injury and Beyond. Cureus [Internet]. 2020 [citado 15 de junio de 2024]; Disponible en: https://www.cureus.com/articles/37377-nephrotoxicity-of-immune-checkpoint-inhibitors-acute-kidney-injury-and-beyond
Uppal NN, Workeneh BT, Rondon-Berrios H, Jhaveri KD. Electrolyte and Acid-Base Disorders Associated with Cancer Immunotherapy. Clin J Am Soc Nephrol. 2022;17(6):922-33.
Wanchoo R, Karam S, Uppal NN, Barta VS, Deray G, Devoe C, et al. Adverse Renal Effects of Immune Checkpoint Inhibitors: A Narrative Review. Am J Nephrol. 2017;45(2):160-9.
Bagchi S, Yuan R, Engleman EG. Immune Checkpoint Inhibitors for the Treatment of Cancer: Clinical Impact and Mechanisms of Response and Resistance. Annu Rev Pathol Mech Dis. 2021;16(1): 223-49.
De Francisco ALM, Macía M, Alonso F, García P, Gutierrez E, Quintana LF, et al. Onco-Nefrología: cáncer, quimioterapia y riñón. Nefrología. 2019;39(5):473-81.
Francis DM, Thomas SN. Progress and opportunities for enhancing the delivery and efficacy of checkpoint inhibitors for cancer immunotherapy. Adv Drug Deliv Rev 2017;114:33-42.
He X, Xu C. Immune checkpoint signaling and cancer immunotherapy. Cell Res. 2020;30(8):660-9.
Herrmann SM, Perazella MA. Immune Checkpoint Inhibitors and Immune-Related Adverse Renal Events. Kidney Int Rep. 2020;5(8):1139-48.
Miao J, Sise ME, Herrmann SM. Immune checkpoint inhibitor related nephrotoxicity: Advances in clinicopathologic features, noninvasive approaches, and therapeutic strategy and rechallenge. Front Nephrol. 2022;2.
Poto R, Troiani T, Criscuolo G, Marone G, Ciardiello F, Tocchetti CG, et al. Holistic Approach to Immune Checkpoint Inhibitor-Related Adverse Events. Front Immunol. 2022;13.
Rao Ullur A, Côté G, Pelletier K, Kitchlu A. Immunotherapy in oncology and the kidneys: a clinical review of the evaluation and management of kidney immune-related adverse events. Clin Kidney J. 2023;16(6):939-51.
Seidel JA, Otsuka A, Kabashima K. Anti-PD-1 and Anti-CTLA-4 Therapies in Cancer: Mechanisms of Action, Efficacy, and Limitations. Front Oncol. 2018;8:86.
Seijas M, Baccino C, Nin N, Lorente JA. Definición y biomarcadores de daño renal agudo: nuevas perspectivas. Med Intensiva. 2014;38(6):376-85.
Shingarev R, Glezerman IG. Kidney Complications of Immune Checkpoint Inhibitors: A Review. Am J Kidney Dis. 2019;74(4):529-37.
Tinawi M, Bastani B. Nephrotoxicity of Immune Checkpoint Inhibitors: Acute Kidney Injury and Beyond. Cureus [Internet]. 2020 [citado 15 de junio de 2024]; Disponible en: https://www.cureus.com/articles/37377-nephrotoxicity-of-immune-checkpoint-inhibitors-acute-kidney-injury-and-beyond
Uppal NN, Workeneh BT, Rondon-Berrios H, Jhaveri KD. Electrolyte and Acid-Base Disorders Associated with Cancer Immunotherapy. Clin J Am Soc Nephrol. 2022;17(6):922-33.
Wanchoo R, Karam S, Uppal NN, Barta VS, Deray G, Devoe C, et al. Adverse Renal Effects of Immune Checkpoint Inhibitors: A Narrative Review. Am J Nephrol. 2017;45(2):160-9.
González, J., Tascón, J., Casanova, A. G., Vicente-Vicente, L., Morales, A. I., & Prieto, M. (2024). Prediction of Immune Checkpoint Inhibitors-Associated Renal Damage in Oncology Patients. FarmaJournal, 9(2), 41–50. https://doi.org/10.14201/fj2024924150
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