Biology of anti-angiogenic therapy-induced thrombotic microangiopathy

Area of Science:

• Oncology
• Nephrology
• Pharmacology

Background:

• Anti-vascular endothelial growth factor (VEGF) agents are crucial targeted therapies for numerous solid tumors.
• The clinical use of anti-VEGF agents is expanding, leading to a projected increase in patient numbers.
• These targeted therapies, while promising, are associated with significant toxicities, particularly affecting the renal system.

Purpose of the Study:

• To review the incidence, pathogenesis, and management of renal toxicities associated with anti-VEGF agents.
• To provide clinicians with an understanding of proteinuria and renal insufficiency in patients receiving anti-VEGF therapy.
• To highlight the importance of monitoring and managing kidney function during anti-VEGF treatment.

Main Methods:

• Literature review of studies investigating anti-VEGF agents and renal toxicities.
• Analysis of reported cases of proteinuria and renal insufficiency in patients treated with anti-VEGF drugs.
• Synthesis of current understanding regarding the mechanisms of VEGF inhibitor-induced nephrotoxicity.

Main Results:

• Proteinuria and renal insufficiency are recognized adverse events associated with anti-VEGF therapy.
• The incidence and severity of these renal toxicities vary depending on the specific agent and treatment duration.
• Pathogenic mechanisms involve disruption of glomerular filtration barrier and renal hemodynamics.

Conclusions:

• Anti-VEGF agents necessitate careful renal monitoring due to potential toxicities.
• Early recognition and management of proteinuria and renal insufficiency are essential for patient safety.
• Further research is needed to optimize the use of anti-VEGF agents while mitigating renal side effects.