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Kidney Toxicities Associated With Novel Cancer Therapies

Joannie Lefebvre1, Ilya G Glezerman1

  • 1Renal Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY; Department of Medicine, Hôpital Maisonneuve-Rosemont, Université de Montréal, Montréal, Canada; and Department of Medicine, Weill Cornell Medical College, New York, NY.

Advances in Chronic Kidney Disease
|August 6, 2017
PubMed

Insights

Targeted cancer therapies can harm kidneys, causing renal side effects. This review covers kidney issues from targeted treatments, their management, and continuing cancer therapy amid renal toxicity.

Area of Science:

  • Oncology
  • Nephrology
  • Pharmacology

Background:

  • Targeted therapies represent a paradigm shift in cancer treatment by interfering with cancer cell growth.
  • While designed for cancer cells, these therapies can affect nonmalignant tissues, leading to various side effects.
  • Renal toxicity is a significant concern associated with numerous targeted cancer therapies.

Purpose of the Study:

  • To review the clinical presentation of kidney side effects caused by targeted therapies.
  • To elucidate the presumed pathophysiology underlying these renal toxicities.
  • To discuss treatment strategies and the feasibility of continuing cancer therapy despite renal toxicity.

Main Methods:

  • Literature review of clinical studies and case reports on targeted therapies and renal side effects.
  • Analysis of reported mechanisms of action for targeted agents and their renal impact.
  • Synthesis of current treatment guidelines and management approaches for nephrotoxicity.

Main Results:

  • Targeted therapies can manifest a spectrum of renal pathologies, including acute kidney injury, chronic kidney disease, and electrolyte disturbances.
  • Specific molecular pathways targeted by cancer drugs are linked to distinct patterns of renal damage.
  • Management strategies often involve dose modification, supportive care, and, in some cases, discontinuation of the offending agent.

Conclusions:

  • Understanding the diverse renal side effects of targeted therapies is crucial for oncologists and nephrologists.
  • Early recognition and appropriate management can mitigate kidney damage and allow for cancer treatment continuation.
  • Further research is needed to develop more kidney-sparing targeted agents and refine management protocols.
Keywords:
Acute kidney failureAnti-angiogenic therapyImmunotherapyKidney toxicityTargeted therapy

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