Evidence map›Paper›PMID 42389519›Full record

ArticleFrontiers in immunology2026

Severe renal and pancreatic toxicities associated with ipilimumab and nivolumab combination therapy in non-small cell lung cancer: a pharmacovigilance analysis of the FDA adverse event reporting system.

Jiongrui Cao, Li Peng, Jin Yang, Gang Yin, Ping Ke, Jifa Zhang, Min Su, Yun Gao, Yuehui Zhang

Abstract read
In one paragraph

Article in Frontiers in immunology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Jiongrui Cao *North Sichuan Medical College, Nanchong, Sichuan, China.
Li Peng *North Sichuan Medical College, Nanchong, Sichuan, China.
Jin Yang *North Sichuan Medical College, Nanchong, Sichuan, China.
Gang YinDepartment of Oncology, Panzhihua Central Hospital, Panzhihua, Sichuan, China.
Ping KeDepartment of Oncology, Panzhihua Central Hospital, Panzhihua, Sichuan, China.
Jifa ZhangDepartment of Oncology, Panzhihua Central Hospital, Panzhihua, Sichuan, China.
Min SuDepartment of Oncology, Panzhihua Central Hospital, Panzhihua, Sichuan, China.
Yun GaoDepartment of Oncology, Panzhihua Central Hospital, Panzhihua, Sichuan, China.
Yuehui ZhangDepartment of Oncology, Panzhihua Central Hospital, Panzhihua, Sichuan, China.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Ipilimumab plus nivolumab (Ipi+Nivo) has become a standard therapy for advanced non-small cell lung cancer (NSCLC), yet severe organ-specific toxicities remain inadequately characterized. This study aimed to characterize severe renal and pancreatic toxicities associated with Ipi+Nivo combination therapy versus nivolumab monotherapy in NSCLC patients. Methods: We analyzed the FDA Adverse Event Reporting System (FAERS) database from 2004 Q1 to 2025 Q2. Disproportionality analysis using reporting odds ratio (ROR) and information component (IC) identified safety signals. Time-to-onset and clinical severity were compared between treatment groups. Results: Among 2,292 reports, combination therapy demonstrated significant disproportionality signals for glomerular-predominant renal injury, including glomerulonephritis minimal lesion (ROR = 78.62, IC025 = 2.096), nephrotic syndrome (ROR = 37.25, IC025 = 1.914), and glomerulosclerosis (ROR = 61.79, IC025 = 2.015). Pancreatic toxicity showed strong signals (ROR = 61.79, IC025 = 2.015). Additional renal signals included nephritis (ROR = 24.99, IC025 = 1.832) and renal failure (ROR = 2.99, IC025 = 0.499). Among 447 combination therapy reports, 39 renal events and 23 pancreatic events were identified, compared to 114 and 48 events respectively in 1,814 monotherapy reports. Median time-to-onset was 73 days for renal events and 84 days for pancreatic events in the combination group. Co-reported renal and pancreatic events were infrequent at the report level (2 of 60 combination therapy reports with renal and/or pancreatic events), and serious clinical outcomes including death and hospitalization were prevalent in both groups without statistically significant between-group differences. Conclusions: Ipi+Nivo combination therapy is associated with prominent glomerular-predominant renal injury and pancreatic toxicity signals, potentially reflecting distinct immunological mechanisms whereby CTLA-4-dependent disruption of B-cell tolerance may predispose to glomerular injury while PD-1-mediated release of T-cell cytotoxicity may preferentially target pancreatic islets. These findings suggest the need for enhanced clinical vigilance and tailored monitoring strategies beyond conventional acute interstitial nephritis surveillance.

Indexed as

Antineoplastic Combined Chemotherapy ProtocolsCarcinoma, Non-Small-Cell LungIpilimumabKidney DiseasesLung NeoplasmsNivolumabPancreatic DiseasesAdverse Drug Reaction Reporting SystemsAgedFemaleHumansMaleMiddle AgedPharmacovigilanceUnited StatesUnited States Food and Drug AdministrationIpilimumabNivolumabglomerulonephritisimmune-related adverse eventsipilimumabnephrotoxicitynivolumabnon-small cell lung cancerpancreatic toxicitypharmacovigilance

Identifiers

PMID42389519
PMCPMC13318663

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.