The renal adverse effects of cancer immunotherapy
Natalie C Steinel1, Ernestine M Lee2, Davide Viggiano3,4
1Department of Biological Sciences, University of Massachusetts Lowell, Lowell, MA, USA.
Abstract:
Over the past decade, the development and clinical use of immunotherapy agents has increased exponentially. As clinical experience builds with these agents so too does our understanding of the associated adverse effects. In particular, the effects of immunotherapy on the kidneys, individual nephrons, and kidney function remain less well described than the adverse effects on barrier organ systems such as the gastrointestinal tract and skin. However, phase IV post-marketing surveillance and clinical case studies together with basic research has begun to reveal mechanisms by which immunotherapy mediates renal adverse effects. This work may lead to improvements in treatment guidelines and therapy. These advances are particularly important as post-cancer survival increases leaving patients to cope with the consequences of not only the cancer, but the short- and long-term adverse effects of treatment. Here we discuss the major renal adverse effects encountered with individual immunotherapeutic agents, putative mechanisms, their current management, and how cancer survivorship programs can help patients who have been treated with immunotherapy.
Insights
Immunotherapy offers cancer treatment benefits but can cause kidney damage. Understanding these renal adverse effects and their mechanisms is crucial for patient care and survivorship.
Area of Science:
- Oncology
- Nephrology
- Immunology
Background:
- Immunotherapy agents have seen exponential development and clinical use over the past decade.
- Adverse effects of immunotherapy are increasingly recognized, particularly on organ systems.
- Renal adverse effects of immunotherapy are less understood than those on the skin or gastrointestinal tract.
Purpose of the Study:
- To describe the major renal adverse effects associated with immunotherapy agents.
- To elucidate the putative mechanisms underlying immunotherapy-mediated kidney damage.
- To discuss current management strategies and the role of survivorship programs for patients experiencing renal adverse effects.
Main Methods:
- Review of phase IV post-marketing surveillance data.
- Analysis of clinical case studies.
- Integration of basic research findings on immunotherapy mechanisms.
Main Results:
- Significant renal adverse effects are linked to specific immunotherapy agents.
- Mechanisms of immunotherapy-induced nephrotoxicity are being uncovered.
- Improved understanding may lead to revised treatment guidelines and enhanced patient management.
Conclusions:
- Increased cancer survival necessitates addressing long-term treatment side effects, including kidney issues.
- Further research into immunotherapy's renal effects is vital for optimizing cancer care.
- Cancer survivorship programs can support patients managing immunotherapy-related kidney complications.
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