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The association between acute kidney injury and outcomes in cancer patients receiving immune checkpoint inhibitor therapy: a systematic review and meta-analysis.


ABSTRACT:

Background

Immune checkpoint inhibitors (ICPIs) are a novel therapeutic approach to cancer treatment that have changed the landscape of cancer therapy but also have some considerable drawbacks. Acute kidney injury (AKI) is one of these potential complications that may have effects on patient outcomes. In this review, we assessed the effect of AKI on mortality outcomes in cancer patients receiving this immunotherapy.

Methods

We performed a systematic review and meta-analysis of prospective, retrospective, randomized and non-randomized studies, which examined the effects of AKI in cancer patients receiving immune checkpoint inhibitors. We searched through PubMed, Medline, Web of Science, Scopus and Cochrane Library databases.

Results

Seven studies were included in the final analysis, with a total number of patients of 761. Overall, the risk of death was higher in patients that developed AKI during ICPI treatment [hazard ratio (HR) 1.42, 95% confidence interval (CI) 1.05-1.92, P = 0.02; heterogeneity χ2 = 11.68, I2 = 66%, P = 0.02] compared with patients that did not develop AKI. In addition, there was a trend to a better survival in those with less severe AKI patients compared with those with more severe AKI (HR 1.35, 95% CI 0.99-1.83, P = 0.05). Lastly, it was seen that patients with persistent kidney dysfunction (non-recovery) had an increased risk for all-cause mortality (HR 2.93, 95% CI 1.41-6.08, P = 0.004; heterogeneity χ2 = 0.53, I2 = 0%, P = 0.47).

Conclusions

Development of AKI in patients with cancer receiving immune checkpoint inhibitors is associated with increased risk of mortality.

SUBMITTER: Kanbay M 

PROVIDER: S-EPMC10157786 | biostudies-literature | 2023 May

REPOSITORIES: biostudies-literature

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The association between acute kidney injury and outcomes in cancer patients receiving immune checkpoint inhibitor therapy: a systematic review and meta-analysis.

Kanbay Mehmet M   Copur Sidar S   Siriopol Dimitrie D   Yildiz Abdullah Burak AB   Berkkan Metehan M   Popa Raluca R   Hasbal Nuri Baris NB   Ortiz Alberto A   Perazella Mark A MA  

Clinical kidney journal 20220831 5


<h4>Background</h4>Immune checkpoint inhibitors (ICPIs) are a novel therapeutic approach to cancer treatment that have changed the landscape of cancer therapy but also have some considerable drawbacks. Acute kidney injury (AKI) is one of these potential complications that may have effects on patient outcomes. In this review, we assessed the effect of AKI on mortality outcomes in cancer patients receiving this immunotherapy.<h4>Methods</h4>We performed a systematic review and meta-analysis of pro  ...[more]

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