Association between cyclin-dependent kinase 4/6 inhibitors and nephrotoxicity in patients with breast cancer: A Systematic Review and meta-analysis

Nephrotoxic adverse events (AEs) have been observed in patients with breast cancer receiving cyclin-dependent kinase (CDK) 4/6 inhibitors. This study aimed to evaluate the risk of nephrotoxicity associated with these inhibitors through a meta-analysis of 17 randomized controlled trials involving 19,638 patients. The results indicate a significant increase in all-grade nephrotoxic AEs, including elevated blood creatinine levels, acute kidney injury, and renal impairment (RR = 3.12, 95% CI [2.11, 4.63]). The incidence of grade 3 or higher nephrotoxicity was also more prevalent among treated patients (RR = 3.12, 95% CI [1.74, 5.58]). Subgroup analyses revealed varying risks among 4 different CDK 4/6 inhibitors. Furthermore, analysis of FDA Adverse Event Reporting System data corroborated these findings, emphasizing the occurrence of nephrotoxicity in real-world settings. Clinicians should remain vigilant in monitoring renal function indicators when prescribing CDK4/6 inhibitors.