Immune checkpoint inhibitors (anti-PD1 or anti-CTLA-4) are increasingly used in various cancers. Immune checkpoint inhibitors (ICI)-related renal disorders are poorly described (9 cases) and were only related to Ipilimumab.
Retrospective collection of clinical charts of all the patients admitted for renal disorders following ICI in the University Hospital of Toulouse (France).
We report on adverse renal events that occurred in three patients treated with anti-PD1 (nivolumab or pembrolizumab) or anti-CTLA-4 (ipilimumab). Acute kidney injury occurred at 4-12 weeks after initiation of treatment, and harbored features of tubulo-interstitial nephritis (interstitial polymorphic inflammatory infiltrate with predominant CD3+ CD4+ T cells, associated with granuloma in one). Following withdrawal of ICI and steroid intake, estimated glomerular-filtration rate had improved in all patients.
These data suggest that all ICI can lead to acute interstitial nephritis, possibly related to the presence of autoreactive clonal T cells. We recommend that patients receiving ICI should undergo renal monitoring every 2 weeks for 3-6 months.British Journal of Cancer advance online publication, 10 November 2016; doi:10.1038/bjc.2016.358 www.bjcancer.com.
British journal of cancer. 2016 Nov 10 [Epub ahead of print]
Julie Belliere, Nicolas Meyer, Julien Mazieres, Sylvie Ollier, Serge Boulinguez, Audrey Delas, David Ribes, Stanislas Faguer
Département de Néphrologie et Transplantation d'organes, Centre de référence des maladies rénales rares, Hôpital Rangueil, Toulouse, France., Service de Dermatologie-Oncologie, Institut Universitaire du Cancer de Toulouse-Oncopôle, Toulouse, France., Université Toulouse-III, Toulouse, France., Service de Médecine interne et Immunologie clinique, Institut Universitaire du Cancer de Toulouse-Oncopôle, Toulouse, France., Laboratoire d'Anatomopathologie, Institut Universitaire du Cancer de Toulouse-Oncopôle, Toulouse, France.