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抗癌免疫疗法的肾脏不良反应:综述

Adverse Renal Effects of Anticancer Immunotherapy: A Review.

作者信息

Borówka Maciej, Łącki-Zynzeling Stanisław, Nicze Michał, Kozak Sylwia, Chudek Jerzy

机构信息

Department of Internal Medicine and Oncological Chemotherapy, Faculty of Medical Sciences in Katowice, Medical University of Silesia, Reymonta 8, 40-027 Katowice, Poland.

出版信息

Cancers (Basel). 2022 Aug 23;14(17):4086. doi: 10.3390/cancers14174086.

Abstract

Modern oncological therapy utilizes various types of immunotherapy. Immune checkpoint inhibitors (ICIs), chimeric antigen receptor T cells (CAR-T) therapy, cancer vaccines, tumor-targeting monoclonal antibodies (TT-mAbs), bispecific antibodies and cytokine therapy improve patients' outcomes. However, stimulation of the immune system, beneficial in terms of fighting against cancer, generates the risk of harm to other cells in a patient's body. Kidney damage belongs to the relatively rare adverse events (AEs). Best described, but still, superficially, are renal AEs in patients treated with ICIs. International guidelines issued by the European Society for Medical Oncology (ESMO) and the American Society of Clinical Oncology (ASCO) cover the management of immune-related adverse events (irAEs) during ICI therapy. There are fewer data concerning real occurrence and possible presentations of renal adverse drug reactions of other immunotherapeutic methods. This implies the need for the collection of safety data during ongoing clinical trials and in the real-life world to characterize the hazard related to the use of new immunotherapies and management of irAEs.

摘要

现代肿瘤治疗采用多种免疫疗法。免疫检查点抑制剂(ICI)、嵌合抗原受体T细胞(CAR-T)疗法、癌症疫苗、肿瘤靶向单克隆抗体(TT-mAb)、双特异性抗体和细胞因子疗法改善了患者的治疗效果。然而,刺激免疫系统虽然有利于对抗癌症,但也会产生损害患者体内其他细胞的风险。肾损伤属于相对罕见的不良事件(AE)。ICI治疗患者的肾脏不良事件描述得最为详尽,但仍较为肤浅。欧洲医学肿瘤学会(ESMO)和美国临床肿瘤学会(ASCO)发布的国际指南涵盖了ICI治疗期间免疫相关不良事件(irAE)的管理。关于其他免疫治疗方法的肾脏药物不良反应的实际发生率和可能表现的数据较少。这意味着需要在正在进行的临床试验和现实世界中收集安全性数据,以描述与使用新免疫疗法相关的风险以及irAE的管理。

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