Onconephrology: What Should the Internist Know About Targeted Therapy in Solid Tumors?

Area of Science:

• Oncology
• Nephrology
• Molecular Biology

Background:

• Cancer treatments are advancing, leading to longer patient survival.
• Molecular oncology is rapidly evolving, with frequent new drug approvals.
• Nephrologists increasingly encounter novel kidney adverse effects from targeted therapies.

Purpose of the Study:

• To review kidney diseases caused by targeted cancer therapies.
• To elucidate the incidence, pathophysiology, and clinical presentation of these adverse effects.
• To provide the first comprehensive management recommendations for each specific pathophysiology.

Main Methods:

• Literature review of targeted therapy agents affecting vascular endothelial growth factor and endothelial growth factor pathways.
• Analysis of reported kidney adverse events and their mechanisms.
• Synthesis of clinical presentations and current management approaches.

Main Results:

• Targeted agents primarily impact kidney function via vascular endothelial growth factor and endothelial growth factor pathways.
• Specific kidney pathologies, including hypertension and proteinuria, are associated with these agents.
• Early recognition and tailored management are crucial for mitigating renal damage.

Conclusions:

• Targeted cancer therapies present unique nephrotoxic profiles.
• Understanding the specific mechanisms of kidney injury is key to effective management.
• This review provides a framework for managing targeted therapy-induced kidney disease.