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Immune checkpoint inhibitor induced nephrotoxicity: An ongoing challenge

Martina Catalano1, Giandomenico Roviello2, Ilaria Camilla Galli3

  • 1School of Human Health Sciences, University of Florence, Florence, Italy.

Frontiers in Medicine
|January 6, 2023
PubMed

Insights

Immune checkpoint inhibitors (ICIs) offer cancer treatment advances but can cause severe immune-related adverse events (irAEs). This review focuses on ICI-induced nephrotoxicity, its challenges, and future research directions.

Area of Science:

  • Oncology
  • Immunology
  • Nephrology

Background:

  • Immune checkpoint inhibitors (ICIs) have transformed cancer therapy.
  • Immune-related adverse events (irAEs) are significant toxicities associated with ICIs.
  • Nephrotoxicity is a less common but serious irAE, often difficult to diagnose.

Purpose of the Study:

  • To review the current understanding of ICI-induced nephrotoxicity.
  • To evaluate the challenges in diagnosing and managing kidney toxicity from ICIs.
  • To discuss future perspectives in the field of ICI-related kidney injury.

Main Methods:

  • Literature review of current knowledge on ICI-induced nephrotoxicity.
  • Analysis of diagnostic challenges and management strategies.
  • Evaluation of existing data and identification of research gaps.

Main Results:

  • ICI-induced nephrotoxicity is underdiagnosed due to subtle or non-specific symptoms.
  • Standard management involves discontinuing ICIs and/or using corticosteroids.
  • Limited data exists on specific mechanisms and long-term outcomes of ICI nephrotoxicity.

Conclusions:

  • ICI-induced nephrotoxicity requires greater clinical attention and improved diagnostic tools.
  • Further research is needed to elucidate mechanisms, refine management, and predict risk.
  • Optimizing the use of ICIs while mitigating kidney-related irAEs is crucial for patient care.
Keywords:
ICI-induced acute kidney injuryimmune checkpoint inhibitorsimmune-related adverse eventsmultidisciplinary managementnephrotoxicity

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