Institute of Academic Medicine and Weill Cornell Medical College, Houston Methodist Cancer Center, Houston Methodist Cancer Center, Houston, TX, USA.
Division of Internal Medicine, Section of Nephrology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
Adv Exp Med Biol. 2021;1342:389-397. doi: 10.1007/978-3-030-79308-1_16.
With the increasing use of immunotherapy, there has been an associated increased survival in many cancers but has also resulted in unregulated organ-specific toxicities. In this review, we will discuss the renal toxicities associated with a checkpoint inhibitor (CPI) from the typical acute tubulointerstitial nephritis to glomerulonephritis and their proposed mechanisms and treatments. We also discuss the use of CPI and reactivation of preexisting autoimmune disease with a focus on renal cell cancer in setting of chronic kidney disease (CKD). Transplant rejection in setting of CPI use has been further evaluated with single-center and multicenter retrospective studies, and available data will be presented in this chapter.
随着免疫疗法的应用日益增多,许多癌症的生存率随之提高,但也导致了不受调节的器官特异性毒性。在这篇综述中,我们将讨论与检查点抑制剂(CPI)相关的肾毒性,从典型的急性肾小管间质性肾炎到肾小球肾炎及其提出的机制和治疗方法。我们还讨论了 CPI 的使用以及慢性肾脏病(CKD)背景下肾细胞癌中原发性自身免疫性疾病的再激活。CPI 使用背景下的移植排斥反应也通过单中心和多中心回顾性研究进行了进一步评估,本章将介绍现有数据。