Renal toxicity of anticancer agents targeting vascular endothelial growth factor (VEGF) and its receptors (VEGFRs)

Abstract

Since angiogenesis plays a key role in tumor growth, progression and metastasization, anti-vascular endothelial growth factor (VEGF)/VEGF receptor (VEGFR) agents have been developed over the years as anticancer agents, and have changed, for the better, the natural history of a number of cancer types. In the present review, the renal safety profile of presently available agents targeting either VEGF or VEGFRs will be discussed, together with the peculiarities related to their clinical use in patients with impaired renal function, or even in dialysis. Indeed, renal toxicity (especially, but not exclusively, hypertension and proteinuria) are quite commonly observed with these agents, and may be increased by the concomitant use of cytoxic chemotherapeutics. Despite all the above, kidney impairment or dialysis must not be regarded di per se as reasons not to administer or to stop an active anticancer treatment, especially considering the possibility of a significant survival improvement in many cancer patients treated with these agents.

Biological agents in gastrointestinal cancers: adverse effects and their management

“…The incidence of all grade proteinuria attributable to angiogenesis inhibition is up to 63%, while the incidence of grade 3-4 proteinuria has been reported to be up to 7% (19). Proteinuria has been correlated with presence of hypertension and the dose of the VEGF inhibitor.…”

Specialists to the Rescue of Oncologists for the Management of Toxicity Occurring Under Combination of Anticancer Therapies

“…5 Only a few case reports have been published describing the efficacy of the combination of crizotinib and EGFR TKIs, and only one with osimertinib. [1][2][3][4] We report here cases showing tumor response with this treatment strategy, even if progression occurred quickly in one patient. Prospective clinical trials are needed to address this issue.…”

“…Immune-related AIN is most often reversible with the suspension of CI and corticosteroids treatment. 2,3 A 63-year-old male with stage IV (lung and brain metastases) lung adenocarcinoma without oncogenic driver developed moderate renal impairment after first-line chemotherapy with cisplatin and pemetrexed leading to treatment discontinuation. Four months later, computed tomographic scan revealed disease progression.…”

“…Only a few reports have been made concerning the treatment of acquired MET amplification in EGFR-mutated adenocarcinoma. [1][2][3][4] We here report the outcomes of two patients treated with an association of EGFR-TKI and crizotinib for EGFR-mutated adenocarcinoma with acquired MET amplification.…”

Expression and role of VEGFA and miR‑381 in portal vein tumor thrombi in patients with hepatocellular carcinoma

“…The development of HCC is dependent on angiogenesis (7). Vascular endothelial growth factor A (VEGFA) serves an important role in the normal physiology and angiogenesis of various abnormal pathologies (8). The expression of VEGF in HCC cells is high due to local hypoxia stimulation, particularly near tumor necrotic areas (9,10).…”