A network meta-analysis of the risk of immune-related renal toxicity in cancer patients treated with immune checkpoint inhibitors

Immunotherapy. 2016 May;8(5):665-74. doi: 10.2217/imt-2015-0020.

Abstract

Background: We performed a network meta-analysis of the risk of immune-related renal toxicity associated with immune checkpoint inhibitors.

Methods: Eligible studies included randomized trials of patients with immune checkpoint inhibitors; describing events of immune-related renal toxicity.

Results: Compared with chemotherapy control, immune checkpoint inhibitors carry a higher risk of all-grade (but not high-grade) immune-related renal toxicity. The risk with both nivolumab/ipilimumab combination was higher than the risk with either ipilimumab or nivolumab alone (odds ratio: 0.47 [95% credible interval: 0.21-0.99] and 0.11 [95% credible interval: 0.03-0.29]); for nivolumab/ipilimumab combination versus ipilimumab or nivolumab monotherapy).

Conclusion: Our meta-analysis demonstrated that the use of immune checkpoint inhibitors is associated with an increased risk of all-grade immune-related renal toxicity compared with chemotherapy control.

Keywords: ipilimumab; nephritis; nivolumab; pembrolizumab.

Publication types

  • Meta-Analysis

MeSH terms

  • Animals
  • Antibodies, Monoclonal / therapeutic use*
  • CTLA-4 Antigen / immunology
  • Carcinoma, Renal Cell / complications
  • Carcinoma, Renal Cell / drug therapy*
  • Drug Therapy, Combination*
  • Drug-Related Side Effects and Adverse Reactions / etiology
  • Drug-Related Side Effects and Adverse Reactions / prevention & control*
  • Humans
  • Ipilimumab
  • Kidney / drug effects*
  • Kidney / pathology
  • Nivolumab
  • Programmed Cell Death 1 Receptor / immunology
  • Randomized Controlled Trials as Topic
  • Risk

Substances

  • Antibodies, Monoclonal
  • CTLA-4 Antigen
  • CTLA4 protein, human
  • Ipilimumab
  • PDCD1 protein, human
  • Programmed Cell Death 1 Receptor
  • Nivolumab