Seydel Florian, Delecluse Susanne, Zeier Martin, Holland-Letz Tim, Haag Georg Martin, Berger Anne Katrin, Grün Barbara Christine, Bougatf Nina, Hohenfellner Markus, Duensing Stefan, Jäger Dirk, Zschäbitz Stefanie
Department of Nephrology, University Hospital Heidelberg, 69120 Heidelberg, Germany.
German Center for Infection Research (DZIF), 69120 Heidelberg, Germany.
Cancers (Basel). 2021 Apr 1;13(7):1623. doi: 10.3390/cancers13071623.
: Checkpoint inhibitors are a standard of care in the treatment of advanced renal cell carcinoma (RCC) and urothelial carcinoma (UC). Patients with these tumors often suffer from concomitant chronic kidney disease (CKD). Limited data are available on the efficacy and toxicity of checkpoint inhibitors in patients with CKD. : We retrospectively analyzed 126 patients who received checkpoint inhibitors for RCC ( = 85) or UC ( = 41) and analyzed the frequency of treatment- and immune-related adverse events (AEs). We performed a multivariate analysis to determine progression-free survival (PFS) and overall survival (OS). : A total of 38.9% of patients had CKD. Frequencies of general AEs (49.0% in CKD vs. 48.1%, > 0.99999) and immune-related AEs (28.6 vs. 24.7%, ≥ 0.9999) did not significantly differ between the groups. There was no difference in PFS for patients with RCC or UC and CKD or without CKD (RCC: 6.81 vs. 7.54 months, HR 1.000 (95%CI 0.548-01.822), = 0.999; UC:2.33 vs. 3.67 months, HR 01.492 (95%CI 0.686-3.247), = 0.431). CKD appeared to be a potential effect modifier for OS in both RCC and UC (RCC: NR vs. 23.9 months, HR 0.502 (95%CI 0.219-1.152), = 0.104; UC:18.84 vs. 15.42 months, HR 0.656 (95%CI 0.296-1.454), = 0.299). : Checkpoint inhibitor treatment in our cohort of patients with CKD was as safe and efficient as in the cohort of patients without CKD.
检查点抑制剂是晚期肾细胞癌（RCC）和尿路上皮癌（UC）治疗的标准疗法。患有这些肿瘤的患者常伴有慢性肾脏病（CKD）。关于检查点抑制剂在CKD患者中的疗效和毒性的数据有限。我们回顾性分析了126例接受检查点抑制剂治疗的RCC患者（n = 85）或UC患者（n = 41），并分析了治疗相关和免疫相关不良事件（AE）的发生频率。我们进行了多因素分析以确定无进展生存期（PFS）和总生存期（OS）。共有38.9%的患者患有CKD。两组之间一般AE的发生频率（CKD组为49.0%，非CKD组为48.1%，P>0.99999）和免疫相关AE的发生频率（28.6%对24.7%，P≥0.9999）无显著差异。RCC或UC伴CKD或不伴CKD的患者在PFS方面无差异（RCC：6.81个月对7.54个月，风险比[HR]1.000[95%置信区间（CI）0.548 - 1.822]，P = 0.999；UC：2.33个月对3.67个月，HR 1.492[95%CI 0.686 - 3.247]，P = 0.431）。CKD似乎是RCC和UC患者OS的潜在效应修饰因素（RCC：未达到[NR]对23.9个月，HR 0.502[95%CI 0.219 - 1.152]，P = 0.104；UC：18.84个月对15.42个月，HR 0.656[95%CI 0.296 - 1.454]，P = 0.299）。在我们的CKD患者队列中，检查点抑制剂治疗与无CKD患者队列一样安全有效。
