Clinical Scorecard: Effects of Tumor Immunotherapy on Renal Damage and Multi-Organ Outcomes: Insights from Mechanistic and Clinical Studies

At a Glance

Key Highlights

• ICIs can induce acute kidney injury, particularly acute tubulointerstitial nephritis (ATIN).
• Renal irAEs occur in 2-5% of patients on anti-PD-1/PD-L1 monotherapy.
• The incidence of renal irAEs increases to 4.9-29% with combination anti-PD-1/CTLA-4 therapies.
• ATIN accounts for 65-80% of ICI-associated kidney injuries.
• Multi-organ involvement, such as myocarditis, is common in ICI-related immune dysregulation.

Guideline-Based Recommendations

Diagnosis

• Monitor for signs of acute kidney injury in patients receiving ICIs.
• Consider biopsy for definitive diagnosis of ATIN in suspected cases.

Management

• Glucocorticoids are the cornerstone therapy for managing renal irAEs.
• Develop strategies for multi-organ protection during ICI therapy.

Monitoring & Follow-up

• Regular renal function tests should be conducted in patients on ICIs.
• Assess for concurrent multi-organ irAEs, particularly myocarditis.

Risks

• Risk of renal injury increases with combination ICI therapies.
• Significant interstudy variability in nephrotoxicity patterns.

Patient & Prescribing Data

Patients with various malignancies treated with ICIs.

Individualized monitoring and management strategies are essential due to variability in response and adverse effects.

Clinical Best Practices

• Integrate clinical and translational evidence to inform treatment strategies.
• Prioritize biomarker-guided approaches for precision in managing renal and multi-organ irAEs.

Related Resources & Content

• Systematic Review on ICI-related Renal Injury