Kidney Week 2025 Annual Meeting-Onconephrology: Updates, Therapies, and Mechanisms

Video Transcription

Video Summary

The session opened with housekeeping notes and then featured multiple onconephrology research presentations focused on kidney complications of cancer and its treatments.<br /><br />First, Dr. Api Chucharat reviewed the controversial role of plasma exchange (PLEX) for myeloma light-chain cast nephropathy. Using a “target trial emulation” across 25 U.S. cancer centers (2010–2024), PLEX within 30 days was not associated with improved 90-day kidney recovery overall; adverse events were similar. A possible benefit appeared only in patients with serum free light chains <10,000 mg/L.<br /><br />Next, Dr. Mundime presented a pilot MD Anderson protocol using single-dose pegloticase for tumor lysis syndrome (TLS). After G6PD screening, pegloticase rapidly lowered uric acid to near-undetectable levels and maintained suppression for weeks, with no dialysis or ICU needs in this small cohort.<br /><br />A Brigham-led multicenter cohort study (STOP TLS) then examined early rasburicase. Among 1,276 hospitalized TLS patients, giving rasburicase within 12 hours of meeting TLS criteria was associated with lower odds of kidney replacement therapy or death, with benefit attenuating after 12 hours.<br /><br />Dr. Susan Zelikowski (Stanford) compared kidney function trajectories after allogeneic stem cell transplant with different GVHD prophylaxis strategies. All groups had substantial 1-year eGFR decline, but ORCA-T showed the smallest decline versus methotrexate, while post-transplant cyclophosphamide had the steepest.<br /><br />Additional talks covered: a mouse study suggesting diacylglycerol lipase-α deletion protects against cisplatin nephrotoxicity; a humanized checkpoint inhibitor mouse model demonstrating inflammatory kidney injury; MSK data linking clonal hematopoiesis (DDR mutations) to AKI risk, especially in estrogen-related cancers; mediation of hypocalcemia by hypomagnesemia (notably with cetuximab and platinums); and evidence that low muscle strength worsens creatinine-based eGFR accuracy in older cancer patients, supporting multi-marker or measured GFR approaches.

Asset Subtitle

Moderator(s): Pooja Amarapurkar, Paul Hanna

Presentation(s):

Plasma Exchange for the Treatment of Light Chain Cast Nephropathy: A Multicenter Study - Api Chewcharat
Pegloticase for Tumor Lysis Syndrome - Sreedhar Mandayam
Early Treatment with Rasburicase and Kidney Replacement Therapy or Death in Patients with Tumor Lysis Syndrome - Tushar Shenoy
Kidney Function After Allogeneic Hematopoietic Cell Transplantation in Patients Treated with Orca-T Cell Therapy, Post-Transplant Cyclophosphamide, or Methotrexate Graft vs. Host Disease Prophylaxis - Susan Ziolkowski
Genetic Deletion of Diacylglycerol Lipase-α, an Endocannabinoid-Producing Enzyme, Protects Against Cisplatin-Induced Nephrotoxicity - Weili Wang, Ningjun Li
Kidney Effects of Immune Checkpoint Inhibitors on a Humanized Chimeric Mouse Model - Victor Cuenca Narvaez
Clonal Hematopoiesis and AKI in Estrogen-Dependent Cancers - Alice Won
Drug-Related Hypocalcemia in Patients with Malignancy: The Mediating Role of Serum Magnesium Levels - Kodai Suzuki
Effect of Low Muscle Strength and CT-Defined Myopenia on the Performance of GFR Estimating Equations in Elderly Patients with Cancer - Veronica Costa e Silva

Note: Continuing education credits are not being offered for this session.

Meta Tag

Date 11/6/2025

Pathway 1 Onconephrology

Session ID 519891

Keywords

onconephrology

plasma exchange (PLEX)

myeloma light-chain cast nephropathy

serum free light chains

tumor lysis syndrome (TLS)

pegloticase

rasburicase

STOP TLS study

kidney replacement therapy (dialysis)

allogeneic stem cell transplant

GVHD prophylaxis (ORCA-T, methotrexate, post-transplant cyclophosphamide)

cisplatin nephrotoxicity

checkpoint inhibitor–associated kidney injury

clonal hematopoiesis and AKI risk