Section of Nephrology, Department of Medicine, Yale University, New Haven, Connecticut; and
Department of Medicine, Veterans Affairs Medical Center, West Haven, Connecticut.
J Am Soc Nephrol. 2018 Aug;29(8):2039-2052. doi: 10.1681/ASN.2018050488. Epub 2018 Jun 29.
Nephrotoxicity from cancer therapies is common and increasingly encountered in clinical practice, such that the subfield of "onco-nephrology" has emerged. Conventional chemotherapeutic drugs and novel agents targeting specific genes/proteins are effective cancer therapies but suffer from a number of adverse kidney effects. An effective avenue of cancer treatment is immunotherapy, which uses drugs that augment immune system-mediated recognition and targeting of tumor cells. As such, leveraging the immune system to target malignant cells represents an important modality in eradicating cancer. IFN and high-dose IL-2 are older immunotherapies used in clinical practice to treat various malignancies, whereas new cancer immunotherapies have emerged over the past decade that offer even more effective treatment options. The immune checkpoint inhibitors are an exciting addition to the cancer immunotherapy armamentarium. Chimeric antigen receptor T cells are also a new immunotherapy used to treat various hematologic malignancies. However, as with the conventional and targeted cancer agents, the immunotherapies are also associated with immune-related adverse effects, which includes nephrotoxicity.
癌症治疗相关的肾毒性较为常见，在临床实践中也越来越常见，因此出现了“肿瘤肾脏病学”这一分支。传统的化疗药物和针对特定基因/蛋白的新型药物是有效的癌症治疗方法，但也存在许多不良的肾脏影响。免疫疗法是癌症治疗的一种有效途径，它使用增强免疫系统介导的肿瘤细胞识别和靶向的药物。因此，利用免疫系统靶向恶性细胞是消除癌症的一种重要方式。IFN 和大剂量 IL-2 是临床上用于治疗各种恶性肿瘤的较老的免疫疗法，而过去十年中出现了新的癌症免疫疗法，提供了更有效的治疗选择。免疫检查点抑制剂是癌症免疫治疗武器库中的一个令人兴奋的补充。嵌合抗原受体 T 细胞也是一种用于治疗各种血液系统恶性肿瘤的新型免疫疗法。然而，与传统和靶向癌症药物一样，免疫疗法也与免疫相关的不良反应相关，包括肾毒性。
