免疫检查点抑制剂的肾脏毒性研究进展

doi:10.19803/j.1672-8629.2019.10.12

中国药物警戒 ›› 2019, Vol. 16 ›› Issue (10): 632-638.
DOI: 10.19803/j.1672-8629.2019.10.12

免疫检查点抑制剂的肾脏毒性研究进展

范倩倩¹, 张波¹, 赵彬¹, 李秋月¹, 刘芳¹, 马杰^{2, *}

1 中国医学科学院北京协和医院药剂科,北京 100730;
2 中国医学科学院北京协和医院肾内科,北京 100730

收稿日期:2019-10-24 修回日期:2019-10-24 出版日期:2019-10-20 发布日期:2019-10-24
通讯作者: 马杰,男,硕士,副主任医师,肾脏内科。E-mail：majie6497@163.com
作者简介:范倩倩,女,博士,主管药师,药物利用与安全性评价研究。
基金资助:
中华医学会临床药学分会-吴阶平医学基金会科研专项基金（320.6750.19090-30）：小分子激酶抑制剂相关急性肾损伤的不良反应信号挖掘与临床分析

Nephrotoxicity of Immune Checkpoint Inhibitors

FAN Qianqian¹, ZHANG Bo¹, ZHAO Bin¹, LI Qiuyue¹, LIU Fang¹, MA Jie^{2, *}

1 Department of Pharmacy, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing 100730, China;
2 Department of Nephrology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing 100730, China

Received:2019-10-24 Revised:2019-10-24 Online:2019-10-20 Published:2019-10-24

摘要/Abstract

摘要： 免疫检查点抑制剂（immune checkpoint inhibitors,ICIs）的发展推动了肿瘤治疗领域的革命性变化,但与此同时,也带来了免疫相关不良事件的新问题。其中,ICIs相关肾脏损伤近年来在国外已有报道,尽管不常见,但可能对患者的药物治疗、生存质量、甚至生命造成威胁,而在国内该类不良反应尚罕有报道。本文通过回顾国内外现有文献报道,对ICIs相关肾脏损伤的特点、监测与治疗进行梳理,旨在为该类药物相关用药决策制定和不良反应管理提供依据。目前的临床证据提示,ICIs相关肾脏损伤以急性肾损伤最为常见,尚有肾病综合征以及肾移植后排斥反应等报道,治疗方案以糖皮质激素为主。ICIs治疗期间密切监测肾功能以及对肾脏损伤的早期发现和干预对结局至关重要。

关键词: 免疫检查点抑制剂, 免疫相关不良事件, 肾脏毒性, 急性肾损伤, 肿瘤肾脏病学

Abstract: The development of immune checkpoint inhibitors (ICIs) has revolutionized the field of cancer therapy. Despite the benefits, the use of ICIs is also accompanied by a unique spectrum of side effects, referred to as immune-related adverse events. Among them, ICIs-related kidney injury has been reported worldwide these years. Although uncommon, such injury may pose a threat to patients' drug treatment, quality of life and even life. So far, such adverse drug reactions have rarely been reported in China. In this paper, the characteristics, monitoring and treatment of ICIs-related kidney injury are summarized based on literature review in order to provide evidence for ICIs-related decision-making and adverse reaction management. Current clinical data suggests that the occurrence of acute kidney injury is relatively more common than other renal complications associated with ICIs use. There are also reports of ICIs-related nephrotic syndrome and kidney transplantation rejection. Glucocorticoid is the mainstay of current treatment. In addition, close monitoring of renal function during ICI treatment, early detection and intervention of kidney injury are critical to the outcome.

Key words: immune checkpoint inhibitor, immune-related adverse event, nephrotoxicity, acute kidney injury, onco-nephrology

中图分类号:

R994.11

范倩倩, 张波, 赵彬, 李秋月, 刘芳, 马杰. 免疫检查点抑制剂的肾脏毒性研究进展[J]. 中国药物警戒, 2019, 16(10): 632-638.

FAN Qianqian, ZHANG Bo, ZHAO Bin, LI Qiuyue, LIU Fang, MA Jie. Nephrotoxicity of Immune Checkpoint Inhibitors[J]. Chinese Journal of Pharmacovigilance, 2019, 16(10): 632-638.

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免疫检查点抑制剂的肾脏毒性研究进展

Nephrotoxicity of Immune Checkpoint Inhibitors

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