Nephrotoxicity of Immune Checkpoint Inhibitors in Single and Combination Therapy—A Systematic and Critical Review

<b>Background/Objectives:</b> Immune checkpoint inhibitors (ICIs) have generated a revolutionary approach in the treatment of cancer, but their effectiveness has been compromised by immune-related adverse events, including renal damage. Although rare, these effects are relevant because t...

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Main Authors: Javier Tascón, Alfredo G. Casanova, Laura Vicente-Vicente, Francisco J. López-Hernández, Ana I. Morales
Format: Article
Language:English
Published: MDPI AG 2025-03-01
Series:Biomedicines
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Online Access:https://www.mdpi.com/2227-9059/13/3/711
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author Javier Tascón
Alfredo G. Casanova
Laura Vicente-Vicente
Francisco J. López-Hernández
Ana I. Morales
author_facet Javier Tascón
Alfredo G. Casanova
Laura Vicente-Vicente
Francisco J. López-Hernández
Ana I. Morales
author_sort Javier Tascón
collection DOAJ
description <b>Background/Objectives:</b> Immune checkpoint inhibitors (ICIs) have generated a revolutionary approach in the treatment of cancer, but their effectiveness has been compromised by immune-related adverse events, including renal damage. Although rare, these effects are relevant because they have been related to poor patient prognoses. The objective of this review was to estimate the current incidence of nephrotoxicity in patients treated with single and double ICI therapies. <b>Methods:</b> A total of 1283 potential articles were identified, which were reduced to 50 after applying the exclusion and inclusion criteria. <b>Results:</b> This study reveals the increase in acute kidney injury associated with these drugs in the last decade and shows that, interestingly, combined therapies with ICIs does not lead to an increase in kidney damage compared with anti-CTLA-4. It also suggests that kidney damage could be underdiagnosed when it comes to interstitial nephritis, because definitive evidence requires a renal biopsy. <b>Conclusions:</b> In perspective, these conclusions could guide clinicians in making decisions for therapy personalization and highlight the need to search for new diagnostic systems that are more sensitive and specific to the type of damage and could replace the biopsy.
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issn 2227-9059
language English
publishDate 2025-03-01
publisher MDPI AG
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series Biomedicines
spelling doaj-art-7a17a46e05874abfa171bdac3d02db7c2025-08-20T02:11:12ZengMDPI AGBiomedicines2227-90592025-03-0113371110.3390/biomedicines13030711Nephrotoxicity of Immune Checkpoint Inhibitors in Single and Combination Therapy—A Systematic and Critical ReviewJavier Tascón0Alfredo G. Casanova1Laura Vicente-Vicente2Francisco J. López-Hernández3Ana I. Morales4Toxicology Unit, Universidad de Salamanca (USAL), 37007 Salamanca, SpainToxicology Unit, Universidad de Salamanca (USAL), 37007 Salamanca, SpainToxicology Unit, Universidad de Salamanca (USAL), 37007 Salamanca, SpainInstituto de Investigación Biomédica de Salamanca (IBSAL), 37007 Salamanca, SpainToxicology Unit, Universidad de Salamanca (USAL), 37007 Salamanca, Spain<b>Background/Objectives:</b> Immune checkpoint inhibitors (ICIs) have generated a revolutionary approach in the treatment of cancer, but their effectiveness has been compromised by immune-related adverse events, including renal damage. Although rare, these effects are relevant because they have been related to poor patient prognoses. The objective of this review was to estimate the current incidence of nephrotoxicity in patients treated with single and double ICI therapies. <b>Methods:</b> A total of 1283 potential articles were identified, which were reduced to 50 after applying the exclusion and inclusion criteria. <b>Results:</b> This study reveals the increase in acute kidney injury associated with these drugs in the last decade and shows that, interestingly, combined therapies with ICIs does not lead to an increase in kidney damage compared with anti-CTLA-4. It also suggests that kidney damage could be underdiagnosed when it comes to interstitial nephritis, because definitive evidence requires a renal biopsy. <b>Conclusions:</b> In perspective, these conclusions could guide clinicians in making decisions for therapy personalization and highlight the need to search for new diagnostic systems that are more sensitive and specific to the type of damage and could replace the biopsy.https://www.mdpi.com/2227-9059/13/3/711immune checkpoint inhibitors (ICIs)acute kidney injurytubulointerstitial nephritisnephrotoxicitysystematic reviewcancer
spellingShingle Javier Tascón
Alfredo G. Casanova
Laura Vicente-Vicente
Francisco J. López-Hernández
Ana I. Morales
Nephrotoxicity of Immune Checkpoint Inhibitors in Single and Combination Therapy—A Systematic and Critical Review
Biomedicines
immune checkpoint inhibitors (ICIs)
acute kidney injury
tubulointerstitial nephritis
nephrotoxicity
systematic review
cancer
title Nephrotoxicity of Immune Checkpoint Inhibitors in Single and Combination Therapy—A Systematic and Critical Review
title_full Nephrotoxicity of Immune Checkpoint Inhibitors in Single and Combination Therapy—A Systematic and Critical Review
title_fullStr Nephrotoxicity of Immune Checkpoint Inhibitors in Single and Combination Therapy—A Systematic and Critical Review
title_full_unstemmed Nephrotoxicity of Immune Checkpoint Inhibitors in Single and Combination Therapy—A Systematic and Critical Review
title_short Nephrotoxicity of Immune Checkpoint Inhibitors in Single and Combination Therapy—A Systematic and Critical Review
title_sort nephrotoxicity of immune checkpoint inhibitors in single and combination therapy a systematic and critical review
topic immune checkpoint inhibitors (ICIs)
acute kidney injury
tubulointerstitial nephritis
nephrotoxicity
systematic review
cancer
url https://www.mdpi.com/2227-9059/13/3/711
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