Acute Renal Failure Associated with Gefitinib Therapy

Wan, Hsiang-Lin; Yao, Nai-Shun

doi:10.1007/s00408-005-2581-0

Cited by 21 publications

(14 citation statements)

References 4 publications

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“…[2][3][4] Although there has been one case reported of gefitinib-induced nephrotic syndrome, 8 acute kidney injury is not a common adverse event and to our knowledge it has only been reported once in a patient of East Asian ethnicity. 9 Our case subject did have mild chronic kidney disease at baseline likely secondary to a combination of hypertensive nephrosclerosis and diabetic glomerulonephropathy. However, his renal function dramatically deteriorated following the introduction of gefitinib and multiple investigations failed to identify a clear precipitating cause.…”

Section: Discussionmentioning

confidence: 71%

Gefitinib-induced Acute Kidney Injury in a Patient with Advanced NSCLC Harbouring an EGFR-activating Mutation

Romanidou¹,

Califano²

2015

European Oncology &Amp; Haematology

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Gefitinib, erlotinib or afatinib represent standard of care as first-line treatment for advanced non-small cell lung cancer (NSCLC) harbouring an activating mutation of epidermal growth factor receptor (EGFR). The toxicity profile of these drugs is well known with rash, diarrhoea, nausea, anorexia, fatigue and derangement of liver function being the most commonly observed adverse events. We report a case of an 82-year-old patient with EGFR-mutant advanced NSCLC who developed gefitinib-induced acute kidney injury, which slowly improved on discontinuation of the drug.

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Section: Discussionmentioning

confidence: 71%

Gefitinib-induced Acute Kidney Injury in a Patient with Advanced NSCLC Harbouring an EGFR-activating Mutation

Romanidou¹,

Califano²

2015

European Oncology &Amp; Haematology

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“…Trastuzumab, which is a related antiendothelial growth factor receptor monoclonal antibody, has been linked to one case of MCD [ 19 ]. Sorafenib, axitinib, gefitinib, imatinib, sunitinib and small molecule tyrosine kinase inhibitors, which target signaling proteins downstream of the VEGF receptor, have been associated with focal segmental glomerulosclerosis (FSGS), ischemic glomerulonephritis, ATN and AIN (see Table 1 ) [ 15 – 30 ]. Sorafenib has recently been linked with MCD as well [ 31 ].…”

Section: Discussionmentioning

confidence: 99%

“…[ 26 ] (compiled in Izzedine et al .) Gefitinib-PO ATN Wan and Yao [ 30 ] (compiled in Izzedine et al .) Imatinib-PO Thrombotic microangiopathy Al aly et al .…”

Section: Discussionmentioning

confidence: 99%

“…There are many reported glomerulopathies that have been reported chronologically and were first compiled by Izzedine et al . [ 19 ] in an article published in the American Journal of Kidney Disease [ 15 – 30 ]. A table was compiled to show all the reported cases of glomerulopathies noted in cases of anti-EGF and anti-VEGF therapies and expanded to include the new cases mentioned above [ 16 – 18 ].…”

Section: Discussionmentioning

confidence: 99%

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Minimal change disease onset observed after bevacizumab administration

Hanna

Lopez

Wilson³

et al. 2015

Clin Kidney J

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This is a report of a patient with minimal change disease (MCD) onset after bevacizumab administration. A 72-year-old man with inoperable Grade 3 astrocytoma was treated with a combination of temozolomide and the vascular endothelial growth factor monoclonal antibody bevacizumab. After two biweekly treatments, he developed nephrotic syndrome. Despite cessation of bevacizumab, his renal function deteriorated and a renal biopsy disclosed MCD. Thereafter, he was started on high-dose oral prednisone and renal function immediately improved. Within weeks, the nephrotic syndrome resolved. Although rare, biologic agents can cause various glomerulopathies that can have important therapeutic implications. MCD should be considered in patients who develop nephrotic syndrome while exposed to antiangiogenic agents.

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“…Other side effects were post-renal acute renal failure due to urinary bleeding or retroperitoneal fibrosis [19]. A case of acute renal failure due to thrombotic thrombocytopenic purpura/hemolytic uremic syndrome was also reported [20]. Reports on the cases causing nephrotic syndrome have been so rare that only a report on minimal change nephrotic syndrome has been presented [21].…”

Section: Discussionmentioning

confidence: 99%

A case of gefitinib-associated membranous nephropathy in treatment for pulmonary adenocarcinoma

et al. 2014

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We experienced a case that was considered as gefitinib-associated membranous nephropathy (MGN) in treatment for pulmonary adenocarcinoma. A female patient aged 80 who had been treated for lung cancer was referred and hospitalized at our hospital, because of nephrotic syndrome. The patient had pulmonary adenocarcinoma (cT4N2M1a) with positive for epidermal growth factor receptor (EGFR) mutation. Gefitinib, EGFR tyrosine kinase inhibitor, was initiated from 1 year and 2 months ago. At that time, proteinuria was negative. The treatment effect on lung cancer was so favorable that partial response had been maintained. However, from 4 months ago, edema of legs appeared, leading to become nephrotic syndrome. Renal biopsy was performed, and secondary MGN was diagnosed, because of deposition of peripheral IgG, mesangial IgA, and C3, as well as the deposition of peripheral IgG4, IgG1, IgG2, and weak IgG3. We considered druginduced MGN and discontinued the administration of gefitinib. Subsequently, the proteinuria tended to decrease gradually and became negative 10 months later. However, the lung cancer recurred 3 months after discontinuation of gefitinib and another molecular target drug, erlotinib, was administered. At present, 13 months after discontinuation of gefitinib, absence of proteinuria is maintained. It has been generally considered that secondary MGN can be induced by both malignant tumor and their treatment. In the present case, the clinical course and pathological characteristics showed the secondary MGN that might be associated with gefitinib during the treatment for pulmonary adenocarcinoma. The present case, to our knowledge, may be a first case of gefitinib-associated MGN.

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Acute Renal Failure Associated with Gefitinib Therapy

Cited by 21 publications

References 4 publications

Gefitinib-induced Acute Kidney Injury in a Patient with Advanced NSCLC Harbouring an EGFR-activating Mutation

Gefitinib-induced Acute Kidney Injury in a Patient with Advanced NSCLC Harbouring an EGFR-activating Mutation

Minimal change disease onset observed after bevacizumab administration

A case of gefitinib-associated membranous nephropathy in treatment for pulmonary adenocarcinoma

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