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Published on: August 19, 2016
New Challenges in the Diagnosis of Kidney Damage Due to Immune Checkpoint Inhibitors Therapy: An Observational
Laura Vicente-Vicente1,2,3,4, Alfredo G Casanova1,2,3,4, Javier Tascón1,2,3,4
1Toxicology Unit, Universidad de Salamanca, 37007 Salamanca, Spain.
Abstract:
In recent years, immunotherapy has been postulated as one of the most effective strategies in the fight against cancer. The greatest success in this field has been achieved with the inhibition of molecules involved in slowing down the adaptive immune response by immune checkpoint inhibitors (ICIs). Despite its efficacy, ICI treatment has side effects. Regarding kidney damage, it is estimated that 4.9% of patients treated with ICIs develop renal injury. Furthermore, cancer patients who develop renal dysfunction have a worse prognosis. Current diagnostics are insufficient to predict the underlying renal injury and to identify the type of damage. Our hypothesis is that the renal injury could be subclinical, so the possibility of using new urinary biomarkers could be a useful diagnostic tool that would allow these patients to be managed in a preventive (risk biomarkers) and early (early biomarkers) way and even to clarify whether the renal damage is due to this therapy or to other factors (differential diagnostic biomarkers). A prospective study to validate risk and early and differential biomarkers in patients treated with ICIs is proposed to test this hypothesis. The results derived from this study will improve the clinical practice of cancer treatment with ICIs and therefore the life expectancy and quality of life of patients. Trial Registration: ClinicalTrials.gov, NCT04902846.
Insights
Immune checkpoint inhibitors (ICIs) can cause kidney damage in cancer patients. New urinary biomarkers may help detect this subclinical renal injury early for better patient outcomes.
Area of Science:
- Oncology
- Nephrology
- Immunology
Background:
- Immunotherapy, particularly immune checkpoint inhibitors (ICIs), is a key cancer treatment.
- ICIs can cause kidney damage (4.9% of patients), worsening prognosis.
- Current diagnostics fail to predict or identify ICI-induced renal injury.
Purpose of the Study:
- To test the hypothesis that subclinical renal injury occurs with ICI treatment.
- To validate novel urinary biomarkers for early detection and differential diagnosis of kidney damage.
- To improve clinical management and patient outcomes during ICI therapy.
Main Methods:
- A prospective study is proposed.
- Validation of risk, early, and differential urinary biomarkers in patients receiving ICIs.
Main Results:
- Results are pending from the prospective validation study.
Conclusions:
- Validated urinary biomarkers could enable preventive and early management of ICI-induced kidney injury.
- Improved diagnostics will enhance clinical practice and patient quality of life.
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