Acute Kidney Injury Associated with Novel Anticancer Therapies: Immunotherapy

Area of Science:

• Oncology
• Nephrology
• Immunology

Background:

• Cancer survival rates have improved due to immunotherapy, including immune checkpoint inhibitors and CAR T-cell therapy.
• These novel cancer treatments can lead to systemic inflammatory toxicities that impact kidney function.
• Adverse events associated with immunotherapy can limit treatment efficacy and pose life-threatening risks.

Purpose of the Study:

• To review the kidney-related toxicities of modern immunotherapies.
• To emphasize the importance of prompt diagnosis and management of these adverse events.
• To highlight strategies for preserving kidney function in cancer patients undergoing immunotherapy.

Main Methods:

• Literature review of adverse events associated with immune checkpoint inhibitors and CAR T-cell therapy.
• Analysis of mechanisms of kidney damage caused by these treatments.
• Discussion of clinical presentation, diagnosis, and management strategies.

Main Results:

• Immune checkpoint inhibitors commonly cause acute interstitial nephritis, potentially leading to therapy discontinuation.
• CAR T-cell therapy can induce cytokine release syndrome and immune effector cell-associated hemophagocytic lympho-histiocytosis, resulting in kidney damage.
• These immune-related adverse events can manifest with diverse kidney pathologies.

Conclusions:

• Kidney toxicities are significant complications of cancer immunotherapies.
• Timely recognition and intervention are essential for managing these adverse events.
• Effective management can preserve renal function and improve overall patient outcomes in cancer care.