Related Experiment Video
Updated: Mar 21, 2026
Chemotherapy-induced Vascular Toxicity - Real-time In vivo Imaging of Vessel Impairment
Published on: January 7, 2015
Renal toxicity of anticancer agents targeting vascular endothelial growth factor (VEGF) and its receptors (VEGFRs)
Laura Cosmai1,2,3, Maurizio Gallieni4,5,6, Wanda Liguigli7
1Division of Nephrology and Dialysis, Ambulatory of Onco-Nephrology, Istituti Ospitalieri Cremona, Largo Priori, 1, 26100, Cremona, Italy. lacos@iol.it.
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.
Insights
Anti-angiogenic therapies targeting vascular endothelial growth factor (VEGF) show efficacy in cancer treatment. However, renal toxicity, including hypertension and proteinuria, is common and requires careful management in patients with kidney impairment or on dialysis.
Area of Science:
- Oncology
- Nephrology
- Pharmacology
Background:
- Angiogenesis is crucial for tumor growth, progression, and metastasis.
- Anti-vascular endothelial growth factor (VEGF)/VEGF receptor (VEGFR) agents are established anticancer therapies.
- These agents have significantly improved outcomes in various cancer types.
Purpose of the Study:
- To review the renal safety profile of current anti-VEGF/VEGFR agents.
- To discuss the clinical use of these agents in patients with impaired renal function or on dialysis.
- To highlight management strategies for renal toxicities associated with these therapies.
Main Methods:
- Literature review of clinical studies and trials.
- Analysis of safety data regarding renal adverse events.
- Evaluation of treatment considerations for specific patient populations.
Main Results:
- Renal toxicities, notably hypertension and proteinuria, are frequent side effects of anti-VEGF/VEGFR agents.
- Concomitant use with cytotoxic chemotherapy may exacerbate renal toxicity.
- Kidney impairment or dialysis status does not necessarily contraindicate treatment.
Conclusions:
- Careful monitoring and management of renal function are essential when using anti-VEGF/VEGFR agents.
- Renal toxicities can often be managed, allowing continued effective cancer treatment.
- These agents offer significant survival benefits, even in patients with pre-existing kidney conditions.
Related Concept Videos
01:24Regulation of Angiogenesis and Blood Supply
01:28Chemotherapy-Induced Nausea and Vomiting: Neurokinin-1 Receptor Antagonists
02:38Mitogens and the Cell Cycle
02:57Targeted Cancer Therapies
There are several types of targeted therapies against...
01:10Mechanism of Angiogenesis
01:18Treatment for Pulmonary Arterial Hypertension: Endothelin Receptor Antagonists
ETs are synthesized through a complex sequence of enzymatic steps, primarily involving an enzyme referred to as endothelin-converting enzyme...