接受免疫检查点抑制剂治疗的癌症患者的肾毒性：一项荟萃分析。
Renal Toxicities in Cancer Patients Receiving Immune-Checkpoint Inhibitors: A Meta-Analysis.
作者信息
Righini Matteo, Mollica Veronica, Rizzo Alessandro, La Manna Gaetano, Massari Francesco
机构信息
Nephrology and Dialysis Unit, Santa Maria delle Croci Hospital, AUSL Romagna, 48121 Ravenna, Italy.
Nephrology, Dialysis and Transplantation Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, University of Bologna, 40126 Bologna, Italy.
出版信息
J Clin Med. 2022 Jul 27;11(15):4373. doi: 10.3390/jcm11154373.
Aim: We performed a meta-analysis of the available clinical trials of immune-checkpoint inhibitors to assess risk differences and relative risks of renal toxicity. Methods: 17 randomized phase III studies were selected, including 10,252 patients. Results: The administration of immune-checkpoint inhibitors resulted in an overall low-grade, high-grade and all-grade renal toxicity Risk Difference of: 0.746% (95% CI 0.629% to 1.15%, p < 0.001—random), 0.61% (95% CI, 0.292−0.929%, p < 0.001—fixed) and 1.2% (95% CI, 0.601−1.85%—random), respectively. The pooled Relative Risk of low-grade, high-grade and all-grade renal toxicity was: 2.185 (95% CI 1.515−3.152—fixed), 2.610 (95% CI, 1.409−4.833, p = 0.002—fixed) and 2.473 (95% CI, 1.782−3.431, p < 0.001—fixed), respectively. An increased risk of renal toxicity was evident in some subgroups more than others. Conclusion: Immune-checkpoint inhibitors are associated with an increased risk of renal toxicity.
目的
我们对免疫检查点抑制剂的现有临床试验进行了荟萃分析，以评估肾毒性的风险差异和相对风险。方法：选择了17项随机III期研究，包括10252名患者。结果：免疫检查点抑制剂的使用导致总体低级别、高级别和所有级别的肾毒性风险差异分别为：0.746%（95%置信区间0.629%至1.15%，p<0.001——随机效应）、0.61%（95%置信区间，0.292−0.929%，p<0.001——固定效应）和1.2%（95%置信区间，0.601−1.85%——随机效应）。低级别、高级别和所有级别的肾毒性合并相对风险分别为：2.185（95%置信区间1.515−3.152——固定效应）、2.610（95%置信区间，1.409−4.833，p = 0.002——固定效应）和2.473（95%置信区间，1.782−3.431，p<0.001——固定效应）。在某些亚组中，肾毒性风险增加比其他亚组更明显。结论：免疫检查点抑制剂与肾毒性风险增加有关。
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