Effect of tislelizumab on the renal function of patients with bladder cancer and hydronephrosis
Objective To explore the impact of tislelizumab on renal function in bladder cancer patients with hydronephrosis Methods A retrospective analysis of 34 bladder cancer patients with hydronephrosis treated at the Second Hospital of Tianjin Medical University from July 2020 to September 2023.Among them,27 were male,and 7 were female,with an average age of(67.41±11.06)years and a body mass index(BMI)of(29.00±7.34)kg/m2.18 patients(52.9％)had hypertension,5(14.7％)had diabetes,and 5(14.7％)had coronary heart disease.The baseline serum creatinine(SCr)was 81.15(69.18,108.90)μmol/L,and the estimated glomerular filtration rate(eGFR)was 73.86(62.17,91.12)ml/(min·1.73m2).Of these,26 patients(76.5％)had eGFR ≥60 ml/(min·1.73m2)(G60+group),and 8 patients(23.5％)had eGFR＜60 ml/(min·1.73m2)(G60-group).10 patients(29.4％)had non-muscle invasive bladder cancer(NMIBC),and 24(70.6％)had muscle-invasive bladder cancer(MIBC).Eleven patients received surgical interventions within 1 month before baseline data collection that might affect hydronephrosis.All 34 patients received tislelizumab(200 mg,intravenous infusion every 3 weeks)combined with albumin-paclitaxel(200 mg,intravenous infusion every 3 weeks).Serum creatinine values were recorded before cycles 1,2,and 3,and 21 days after cycle 3(Cr1,Cr2,Cr3,CrE),and corresponding eGFR values(eGFR1,eGFR2,eGFR3,eGFRE)were calculated.A reduction in eGFR＞25％from baseline at any of these points was defined as a decline in renal function(DRF),and an increase in eGFR＞25％was defined as improvement in renal function(IRF).Differences in renal function changes and IRF,DRF incidence rates were compared between baseline subgroups Results After 3 cycles of tislelizumab treatment,there was no significant change in eGFR[]eGFR1 vs.eGFRE,73.86(62.16,91.12)ml/(min·1.73m2)vs.83.82(60.32,90.62)ml/(min·1.73m2),P=0.197].Subgroup analysis showed that patients with diabetes had a significant increase in CrE compared to Cr1(88.90μmol/L vs.69.40 μmol/L,P=0.043)and a significant decrease in eGFRE compared to eGFR1[76.47 ml/(min·1.73m2)vs.87.73 ml/(min·1.73m2),P=0.043].No significant differences were observed in the other subgroups for SCr and eGFR within or between groups.DRF occurred in 4 patients(11.8％),with 1 diagnosed with acute renal injury,but not immune-related.IRF occurred in 8 patients(22.9％).In the subgroup analysis,the IRF incidence was significantly higher in the G60-group compared to the G60+group(50.0％vs.15.4％,P=0.044).No other factors were found to be associated with DRF or IRF.Conclusions Tislelizumab treatment is safe for renal function in bladder cancer patients with hydronephrosis.Most patients with baseline poor renal function or underlying conditions like hypertension,diabetes,or coronary heart disease showed stable renal function during treatment.
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