Acute kidney injury in patients treated with anti-programmed death receptor-1 for advanced melanoma: a real-life study in a single-centre cohort
Abstract Background Immune checkpoints inhibitors have transformed the prognosis of advanced melanoma but are associated with immune-related adverse events (irAEs). We evaluated the incidence, risk factors and causes of acute kidney injury (AKI) in a monocentric real-life cohort of patients treated...
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| Veröffentlicht in: | Nephrology, dialysis, transplantation dialysis, transplantation, 2021-08, Vol.36 (9), p.1664-1674 |
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| creator | Stein, Claire Burtey, Stéphane Mancini, Julien Pelletier, Marion Sallée, Marion Brunet, Philippe Berbis, Philippe Grob, Jean Jacques Honoré, Stéphane Gaudy, Caroline Jourde-Chiche, Noémie |
| description | Abstract
Background
Immune checkpoints inhibitors have transformed the prognosis of advanced melanoma but are associated with immune-related adverse events (irAEs). We evaluated the incidence, risk factors and causes of acute kidney injury (AKI) in a monocentric real-life cohort of patients treated with anti-programmed death receptor-1 (anti-PD1) antibodies for advanced melanoma.
Methods
Retrospective collection of medical charts and comprehensive analysis of lab results from patients treated with nivolumab or pembrolizumab for advanced melanoma between 2014 and 2018 was carried out. AKI was defined by Kidney Disease Improving Global Outcomes criteria, and causes were determined by chart review. Overall survival, survival without AKI and impact of AKI on survival were analysed. Risk factors for death and for AKI were identified.
Results
Two hundred and thirty-nine patients were included. Forty-one (17%) had at least one episode of AKI. Independent risk factors for AKI were treatment with renin–angiotensin–aldosterone system inhibitors (RAASi), pre-existing chronic kidney disease (CKD) and cumulated doses of anti-PD1. The main cause of AKI was prerenal, and only eight patients (3.3%) developed acute interstitial nephritis; 8% of patients developed CKD. The median overall survival was 13.4 months and was not affected by AKI. In multivariate analysis, the overall mortality was lower in overweight and obese patients and higher in patients treated with proton-pump inhibitors (PPI) or corticosteroids.
Conclusions
AKI is common in patients treated with anti-PD1 for advanced melanoma but is mostly prerenal and favoured by the use of RAASi; renal irAE is rare. PPI and corticosteroids were associated with poor survival in this population, while overweight/obesity was protective.
GRAPHICAL ABSTRACT |
| doi_str_mv | 10.1093/ndt/gfaa137 |
| format | Article |
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Background
Immune checkpoints inhibitors have transformed the prognosis of advanced melanoma but are associated with immune-related adverse events (irAEs). We evaluated the incidence, risk factors and causes of acute kidney injury (AKI) in a monocentric real-life cohort of patients treated with anti-programmed death receptor-1 (anti-PD1) antibodies for advanced melanoma.
Methods
Retrospective collection of medical charts and comprehensive analysis of lab results from patients treated with nivolumab or pembrolizumab for advanced melanoma between 2014 and 2018 was carried out. AKI was defined by Kidney Disease Improving Global Outcomes criteria, and causes were determined by chart review. Overall survival, survival without AKI and impact of AKI on survival were analysed. Risk factors for death and for AKI were identified.
Results
Two hundred and thirty-nine patients were included. Forty-one (17%) had at least one episode of AKI. Independent risk factors for AKI were treatment with renin–angiotensin–aldosterone system inhibitors (RAASi), pre-existing chronic kidney disease (CKD) and cumulated doses of anti-PD1. The main cause of AKI was prerenal, and only eight patients (3.3%) developed acute interstitial nephritis; 8% of patients developed CKD. The median overall survival was 13.4 months and was not affected by AKI. In multivariate analysis, the overall mortality was lower in overweight and obese patients and higher in patients treated with proton-pump inhibitors (PPI) or corticosteroids.
Conclusions
AKI is common in patients treated with anti-PD1 for advanced melanoma but is mostly prerenal and favoured by the use of RAASi; renal irAE is rare. PPI and corticosteroids were associated with poor survival in this population, while overweight/obesity was protective.
GRAPHICAL ABSTRACT</description><identifier>ISSN: 0931-0509</identifier><identifier>EISSN: 1460-2385</identifier><identifier>DOI: 10.1093/ndt/gfaa137</identifier><identifier>PMID: 32941608</identifier><language>eng</language><publisher>England: Oxford University Press</publisher><subject>Acute Kidney Injury - chemically induced ; Antibodies, Monoclonal, Humanized - adverse effects ; Humans ; Life Sciences ; Melanoma - drug therapy ; Nivolumab - adverse effects ; Receptors, Death Domain - antagonists & inhibitors ; Retrospective Studies</subject><ispartof>Nephrology, dialysis, transplantation, 2021-08, Vol.36 (9), p.1664-1674</ispartof><rights>The Author(s) 2020. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved. 2021</rights><rights>The Author(s) 2020. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved.</rights><rights>Distributed under a Creative Commons Attribution 4.0 International License</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c357t-4659dc02b4540c1afbbf7e2485a79aadfc20010ca2833191e2e5e2cb8645ee4d3</citedby><cites>FETCH-LOGICAL-c357t-4659dc02b4540c1afbbf7e2485a79aadfc20010ca2833191e2e5e2cb8645ee4d3</cites><orcidid>0000-0001-9315-1577 ; 0000-0001-9500-8598</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,776,780,881,1578,27903,27904</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32941608$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink><backlink>$$Uhttps://inserm.hal.science/inserm-03106263$$DView record in HAL$$Hfree_for_read</backlink></links><search><creatorcontrib>Stein, Claire</creatorcontrib><creatorcontrib>Burtey, Stéphane</creatorcontrib><creatorcontrib>Mancini, Julien</creatorcontrib><creatorcontrib>Pelletier, Marion</creatorcontrib><creatorcontrib>Sallée, Marion</creatorcontrib><creatorcontrib>Brunet, Philippe</creatorcontrib><creatorcontrib>Berbis, Philippe</creatorcontrib><creatorcontrib>Grob, Jean Jacques</creatorcontrib><creatorcontrib>Honoré, Stéphane</creatorcontrib><creatorcontrib>Gaudy, Caroline</creatorcontrib><creatorcontrib>Jourde-Chiche, Noémie</creatorcontrib><title>Acute kidney injury in patients treated with anti-programmed death receptor-1 for advanced melanoma: a real-life study in a single-centre cohort</title><title>Nephrology, dialysis, transplantation</title><addtitle>Nephrol Dial Transplant</addtitle><description>Abstract
Background
Immune checkpoints inhibitors have transformed the prognosis of advanced melanoma but are associated with immune-related adverse events (irAEs). We evaluated the incidence, risk factors and causes of acute kidney injury (AKI) in a monocentric real-life cohort of patients treated with anti-programmed death receptor-1 (anti-PD1) antibodies for advanced melanoma.
Methods
Retrospective collection of medical charts and comprehensive analysis of lab results from patients treated with nivolumab or pembrolizumab for advanced melanoma between 2014 and 2018 was carried out. AKI was defined by Kidney Disease Improving Global Outcomes criteria, and causes were determined by chart review. Overall survival, survival without AKI and impact of AKI on survival were analysed. Risk factors for death and for AKI were identified.
Results
Two hundred and thirty-nine patients were included. Forty-one (17%) had at least one episode of AKI. Independent risk factors for AKI were treatment with renin–angiotensin–aldosterone system inhibitors (RAASi), pre-existing chronic kidney disease (CKD) and cumulated doses of anti-PD1. The main cause of AKI was prerenal, and only eight patients (3.3%) developed acute interstitial nephritis; 8% of patients developed CKD. The median overall survival was 13.4 months and was not affected by AKI. In multivariate analysis, the overall mortality was lower in overweight and obese patients and higher in patients treated with proton-pump inhibitors (PPI) or corticosteroids.
Conclusions
AKI is common in patients treated with anti-PD1 for advanced melanoma but is mostly prerenal and favoured by the use of RAASi; renal irAE is rare. PPI and corticosteroids were associated with poor survival in this population, while overweight/obesity was protective.
GRAPHICAL ABSTRACT</description><subject>Acute Kidney Injury - chemically induced</subject><subject>Antibodies, Monoclonal, Humanized - adverse effects</subject><subject>Humans</subject><subject>Life Sciences</subject><subject>Melanoma - drug therapy</subject><subject>Nivolumab - adverse effects</subject><subject>Receptors, Death Domain - antagonists & inhibitors</subject><subject>Retrospective Studies</subject><issn>0931-0509</issn><issn>1460-2385</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kU9v1DAQxS0EotvCiTvyCSFBqP8lTritKkqRVuICZ2viTHZdEjvYTlG_BR8Zl1165PSkeT-90cwj5BVnHzjr5KUf8uV-BOBSPyEbrhpWCdnWT8mmuLxiNevOyHlKt4yxTmj9nJxJ0SnesHZDfm_tmpH-cIPHe-r87RofhC6QHfqcaI4IGQf6y-UDBZ9dtcSwjzDPZTgU70AjWlxyiBWnY4gUhjvwtrgzTuDDDB8pFAamanIj0pTX4e8KoMn5_YSVLYsiUhsOIeYX5NkIU8KXJ70g368_fbu6qXZfP3-52u4qK2udK9XU3WCZ6FWtmOUw9v2oUai2Bt0BDKMVjHFmQbRS8o6jwBqF7dtG1YhqkBfk_TH3AJNZopsh3psAztxsd8b5hHE2THLWiEbe8YK_PeLl-p8rpmxmlyxO5UIMazJCKSW11g0r6LsjamNIKeL4GM-ZeWjMlMbMqbFCvz4Fr3156SP7r6ICvDkCYV3-m_QHdTKhUQ</recordid><startdate>20210827</startdate><enddate>20210827</enddate><creator>Stein, Claire</creator><creator>Burtey, Stéphane</creator><creator>Mancini, Julien</creator><creator>Pelletier, Marion</creator><creator>Sallée, Marion</creator><creator>Brunet, Philippe</creator><creator>Berbis, Philippe</creator><creator>Grob, Jean Jacques</creator><creator>Honoré, Stéphane</creator><creator>Gaudy, Caroline</creator><creator>Jourde-Chiche, Noémie</creator><general>Oxford University Press</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>1XC</scope><scope>VOOES</scope><orcidid>https://orcid.org/0000-0001-9315-1577</orcidid><orcidid>https://orcid.org/0000-0001-9500-8598</orcidid></search><sort><creationdate>20210827</creationdate><title>Acute kidney injury in patients treated with anti-programmed death receptor-1 for advanced melanoma: a real-life study in a single-centre cohort</title><author>Stein, Claire ; Burtey, Stéphane ; Mancini, Julien ; Pelletier, Marion ; Sallée, Marion ; Brunet, Philippe ; Berbis, Philippe ; Grob, Jean Jacques ; Honoré, Stéphane ; Gaudy, Caroline ; Jourde-Chiche, Noémie</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c357t-4659dc02b4540c1afbbf7e2485a79aadfc20010ca2833191e2e5e2cb8645ee4d3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Acute Kidney Injury - chemically induced</topic><topic>Antibodies, Monoclonal, Humanized - adverse effects</topic><topic>Humans</topic><topic>Life Sciences</topic><topic>Melanoma - drug therapy</topic><topic>Nivolumab - adverse effects</topic><topic>Receptors, Death Domain - antagonists & inhibitors</topic><topic>Retrospective Studies</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Stein, Claire</creatorcontrib><creatorcontrib>Burtey, Stéphane</creatorcontrib><creatorcontrib>Mancini, Julien</creatorcontrib><creatorcontrib>Pelletier, Marion</creatorcontrib><creatorcontrib>Sallée, Marion</creatorcontrib><creatorcontrib>Brunet, Philippe</creatorcontrib><creatorcontrib>Berbis, Philippe</creatorcontrib><creatorcontrib>Grob, Jean Jacques</creatorcontrib><creatorcontrib>Honoré, Stéphane</creatorcontrib><creatorcontrib>Gaudy, Caroline</creatorcontrib><creatorcontrib>Jourde-Chiche, Noémie</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>Hyper Article en Ligne (HAL)</collection><collection>Hyper Article en Ligne (HAL) (Open Access)</collection><jtitle>Nephrology, dialysis, transplantation</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Stein, Claire</au><au>Burtey, Stéphane</au><au>Mancini, Julien</au><au>Pelletier, Marion</au><au>Sallée, Marion</au><au>Brunet, Philippe</au><au>Berbis, Philippe</au><au>Grob, Jean Jacques</au><au>Honoré, Stéphane</au><au>Gaudy, Caroline</au><au>Jourde-Chiche, Noémie</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Acute kidney injury in patients treated with anti-programmed death receptor-1 for advanced melanoma: a real-life study in a single-centre cohort</atitle><jtitle>Nephrology, dialysis, transplantation</jtitle><addtitle>Nephrol Dial Transplant</addtitle><date>2021-08-27</date><risdate>2021</risdate><volume>36</volume><issue>9</issue><spage>1664</spage><epage>1674</epage><pages>1664-1674</pages><issn>0931-0509</issn><eissn>1460-2385</eissn><abstract>Abstract
Background
Immune checkpoints inhibitors have transformed the prognosis of advanced melanoma but are associated with immune-related adverse events (irAEs). We evaluated the incidence, risk factors and causes of acute kidney injury (AKI) in a monocentric real-life cohort of patients treated with anti-programmed death receptor-1 (anti-PD1) antibodies for advanced melanoma.
Methods
Retrospective collection of medical charts and comprehensive analysis of lab results from patients treated with nivolumab or pembrolizumab for advanced melanoma between 2014 and 2018 was carried out. AKI was defined by Kidney Disease Improving Global Outcomes criteria, and causes were determined by chart review. Overall survival, survival without AKI and impact of AKI on survival were analysed. Risk factors for death and for AKI were identified.
Results
Two hundred and thirty-nine patients were included. Forty-one (17%) had at least one episode of AKI. Independent risk factors for AKI were treatment with renin–angiotensin–aldosterone system inhibitors (RAASi), pre-existing chronic kidney disease (CKD) and cumulated doses of anti-PD1. The main cause of AKI was prerenal, and only eight patients (3.3%) developed acute interstitial nephritis; 8% of patients developed CKD. The median overall survival was 13.4 months and was not affected by AKI. In multivariate analysis, the overall mortality was lower in overweight and obese patients and higher in patients treated with proton-pump inhibitors (PPI) or corticosteroids.
Conclusions
AKI is common in patients treated with anti-PD1 for advanced melanoma but is mostly prerenal and favoured by the use of RAASi; renal irAE is rare. PPI and corticosteroids were associated with poor survival in this population, while overweight/obesity was protective.
GRAPHICAL ABSTRACT</abstract><cop>England</cop><pub>Oxford University Press</pub><pmid>32941608</pmid><doi>10.1093/ndt/gfaa137</doi><tpages>11</tpages><orcidid>https://orcid.org/0000-0001-9315-1577</orcidid><orcidid>https://orcid.org/0000-0001-9500-8598</orcidid><oa>free_for_read</oa></addata></record> |
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| identifier | ISSN: 0931-0509 |
| ispartof | Nephrology, dialysis, transplantation, 2021-08, Vol.36 (9), p.1664-1674 |
| issn | 0931-0509 1460-2385 |
| language | eng |
| recordid | cdi_hal_primary_oai_HAL_inserm_03106263v1 |
| source | MEDLINE; Oxford University Press Journals All Titles (1996-Current); EZB-FREE-00999 freely available EZB journals; Alma/SFX Local Collection |
| subjects | Acute Kidney Injury - chemically induced Antibodies, Monoclonal, Humanized - adverse effects Humans Life Sciences Melanoma - drug therapy Nivolumab - adverse effects Receptors, Death Domain - antagonists & inhibitors Retrospective Studies |
| title | Acute kidney injury in patients treated with anti-programmed death receptor-1 for advanced melanoma: a real-life study in a single-centre cohort |
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