Related Experiment Video
Updated: Apr 21, 2026
Induction of Nephrotic Syndrome in Mice by Retrobulbar Injection of Doxorubicin and Prevention of Volume Retention by Sustained Release Aprotinin
Published on: May 6, 2018
Incidence and risk of proteinuria with aflibercept in cancer patients: a meta-analysis
Ling Peng1, Qiong Zhao1, Xianghua Ye2
1Department of Thoracic Oncology, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, China.
Background:
Aflibercept is a human recombinant fusion protein with antiangiogenic effects that functions as a decoy receptor to bind vascular endothelial growth factor A. Proteinuria is one of its major adverse effects with a substantial variation in the incidence rate, and the overall risk of proteinuria has not been systematically studied. We performed a meta-analysis of published clinical trials to quantify the incidence and relative risk of proteinuria in cancer patients treated with aflibercept.
Methods:
The electronic databases were searched, including PubMed, Embase, Cochrane databases, and ASCO (American Society of Clinical Oncology) abstracts. Eligible studies were phase II and III prospective clinical trials of cancer patients treated with aflibercept with toxicity data on proteinuria. Overall incidence rates, relative risk (RR), and 95% confidence intervals (CI) were calculated using fixed or random effects models depending on the heterogeneity of the included studies.
Results:
A total of 4,596 patients with a variety of solid tumors from 16 prospective clinical trials were included for the meta-analysis. The overall incidences of all-grade and high-grade proteinuria in cancer patients were 33.9% (95% CI: 27.3-42.1%) and 7.9% (95% CI: 6.1-10.2%). The relative risks of proteinuria of aflibercept compared to control were increased for all-grade (RR = 1.41, 95% CI: 1.13-1.77) and high-grade (RR = 6.18, 95% CI: 3.78-10.12) proteinuria. The risk of developing all-grade and high-grade proteinuria with aflibercept was substantially higher than that of bevacizumab (all-grade: RR 1.85, 95% CI: 1.63-2.11; high-grade: RR 2.37, 95% CI: 1.84-3.05).
Conclusions:
Aflibercept is associated with an increased risk of developing proteinuria. Appropriate monitoring and treatment is strongly recommended to prevent potential renal damage. Future studies are still needed to investigate the risk reduction and possible use of aflibercept in cancer patients.
Insights
Aflibercept treatment increases the risk of proteinuria in cancer patients. This meta-analysis found higher incidences and relative risks of proteinuria compared to controls and bevacizumab, necessitating careful monitoring for renal damage.
Area of Science:
- Oncology
- Pharmacology
- Nephrology
Background:
- Aflibercept is an antiangiogenic fusion protein targeting VEGF-A.
- Proteinuria is a known adverse effect of aflibercept, but its overall risk is not well-established.
- This study systematically evaluates proteinuria incidence and risk in cancer patients receiving aflibercept.
Purpose of the Study:
- To quantify the incidence of all-grade and high-grade proteinuria in cancer patients treated with aflibercept.
- To determine the relative risk of proteinuria associated with aflibercept compared to control groups.
- To compare the risk of proteinuria between aflibercept and bevacizumab.
Main Methods:
- A meta-analysis of prospective phase II and III clinical trials was conducted.
- Literature search included PubMed, Embase, Cochrane, and ASCO abstracts.
- Incidence rates and relative risks (RR) with 95% confidence intervals (CI) were calculated using fixed or random effects models.
Main Results:
- 16 trials including 4,596 patients with solid tumors were analyzed.
- Overall incidences were 33.9% for all-grade and 7.9% for high-grade proteinuria.
- Aflibercept significantly increased all-grade (RR=1.41) and high-grade (RR=6.18) proteinuria risk versus controls, and was higher than bevacizumab.
Conclusions:
- Aflibercept is associated with a significantly increased risk of developing proteinuria.
- Close monitoring and prompt treatment are crucial to prevent potential renal complications.
- Further research is needed to explore risk reduction strategies and optimal aflibercept use in oncology.
