Cui Jiayong, Sun Jinquan, Zhou Xueying, Li Yi, Zhao Jiuda, Shen Guoshuang
Breast Disease Diagnosis and Treatment Center, Affiliated Hospital of Qinghai University, Xining, China.
iScience. 2024 Nov 12;27(12):111370. doi: 10.1016/j.isci.2024.111370. eCollection 2024 Dec 20.
Nephrotoxic adverse events (AEs) have been observed in patients with breast cancer receiving cyclin-dependent kinase (CDK) 4/6 inhibitors. This study aimed to evaluate the risk of nephrotoxicity associated with these inhibitors through a meta-analysis of 17 randomized controlled trials involving 19,638 patients. The results indicate a significant increase in all-grade nephrotoxic AEs, including elevated blood creatinine levels, acute kidney injury, and renal impairment (RR = 3.12, 95% CI [2.11, 4.63]). The incidence of grade 3 or higher nephrotoxicity was also more prevalent among treated patients (RR = 3.12, 95% CI [1.74, 5.58]). Subgroup analyses revealed varying risks among 4 different CDK 4/6 inhibitors. Furthermore, analysis of FDA Adverse Event Reporting System data corroborated these findings, emphasizing the occurrence of nephrotoxicity in real-world settings. Clinicians should remain vigilant in monitoring renal function indicators when prescribing CDK4/6 inhibitors.
在接受细胞周期蛋白依赖性激酶（CDK）4/6抑制剂治疗的乳腺癌患者中，已观察到肾毒性不良事件（AE）。本研究旨在通过对17项涉及19638例患者的随机对照试验进行荟萃分析，评估与这些抑制剂相关的肾毒性风险。结果表明，包括血肌酐水平升高、急性肾损伤和肾功能损害在内的所有级别的肾毒性AE显著增加（RR = 3.12，95%CI [2.11, 4.63]）。3级或更高等级肾毒性的发生率在接受治疗的患者中也更为普遍（RR = 3.12，95%CI [1.74, 5.58]）。亚组分析显示，4种不同的CDK 4/6抑制剂之间的风险各不相同。此外，对美国食品药品监督管理局不良事件报告系统数据的分析证实了这些发现，强调了在现实环境中肾毒性的发生。临床医生在开具CDK4/6抑制剂处方时，应保持警惕，监测肾功能指标。
