Study Reveals Kidney Damage Linked to Immunotherapy in Cancer Patients

Overview of Immunotherapy

A recent study has highlighted the potential side effects of immunotherapy, particularly its association with kidney damage in cancer patients. Immunotherapy utilizes specific components of the immune system to combat certain cancer cells, with immune checkpoint inhibitors being one notable category of medication used in this treatment.

Research Findings from Massachusetts General Hospital

Researchers at Massachusetts General Hospital investigated the link between immune checkpoint inhibitors and Acute Kidney Injury (AKI), which is characterized by kidney failure or damage occurring within a short timeframe. The study aimed to ascertain the frequency, severity, and underlying causes of AKI in patients undergoing treatment with these inhibitors.

The research analyzed data from all patients treated with immune checkpoint inhibitors at the hospital between 2011 and 2016. Participants included those who had their creatinine levels measured six months prior to and within 12 months following the start of their treatment. AKI was diagnosed based on a significant increase in creatinine levels; specifically, a post-treatment creatinine level exceeding 1.5 times the pre-treatment level indicated AKI.

Patient Demographics and AKI Incidence

The analysis encompassed 1,016 patients, with an average age of 61 years. Findings revealed that 169 patients (17%) experienced AKI, while 82 patients (8%) suffered from sustained AKI—defined as AKI lasting 2-3 days. Additionally, 30 patients (3%) displayed potential checkpoint inhibitor-related AKI. The onset of sustained AKI typically occurred, on average, 106 days after the initiation of checkpoint inhibitor therapy.

The study also identified a correlation between the use of Proton Pump Inhibitors (PPIs), commonly prescribed for stomach ulcers and acid reflux, and the occurrence of sustained AKI at the time of starting checkpoint inhibitor treatment.

Significance of the Study

This study represents the largest evaluation of AKI among patients receiving checkpoint inhibitors for cancer treatment and is the first to systematically define the incidence of inhibitor-related AKI.

Dr. Meghan Sise (MD), one of the researchers, noted, “We believe that nephrologists are going to be increasingly called upon to determine the cause of AKI in patients on immune checkpoint inhibitors, and making an accurate diagnosis has huge implications for therapy for a patient’s cancer treatment going forward.”

References

– Harish Seethapathy, Sophia Zhao, Donald F. Chute, Leyre Zubiri, Yaa Oppong, Ian Strohbehn, Frank B. Cortazar, David E. Leaf, Meghan J. Mooradian, Alexandra-Chloé Villani, Ryan J. Sullivan, Kerry Reynolds, Meghan E. Sise. The Incidence, Causes, and Risk Factors of Acute Kidney Injury in Patients Receiving Immune Checkpoint Inhibitors. CJASN Oct 2019.
– EurekAlert! (news release 31 October 2019) Study examines kidney injury in patients taking immunotherapy cancer medications. https://www.eurekalert.org/pub_releases/2019-10/ason-sek102519.php