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[Renal toxicities of targeted therapies in oncology]

Hassan Izzedine1

  • 1Ramsay GDS, service de néphrologie, hôpital privé des Peupliers, 8, place de l'Abbé-Henocque, 75013 Paris, France.

Nephrologie & Therapeutique
|December 11, 2019
PubMed

Insights

Targeted cancer therapies improve survival but can cause kidney damage. This review details renal toxicities from specific targeted agents and emphasizes early diagnosis and management for better patient outcomes.

Area of Science:

  • Oncology
  • Nephrology
  • Pharmacology

Background:

  • Targeted therapies represent a significant advancement in cancer treatment, improving patient survival compared to traditional chemotherapy.
  • While effective, these novel anticancer agents are increasingly recognized for their potential to cause renal toxicities.
  • The specific type and incidence of kidney damage vary depending on the targeted molecular pathway.

Purpose of the Study:

  • To review the spectrum of renal toxicities associated with various targeted anticancer therapies.
  • To provide clinicians with an overview of adverse renal events linked to specific targeted agents.
  • To highlight the importance of early recognition and management of these toxicities.

Main Methods:

  • Literature review of targeted anticancer therapies and their associated renal toxicities.
  • Focused analysis on agents targeting Epidermal Growth Factor Receptor (EGFR), Human Epidermal Growth Factor-2 (HER2), B-rapidly accelerated fibrosarcoma (BRAF), Mitogen-activated protein kinase (MAPK), Anaplastic Lymphoma Kinase (ALK), Programmed Cell Death-1 (PD-1)/Programmed Cell Death Ligand-1 (PD-L1), Cytotoxic T Lymphocyte Antigen-4 (CTLA-4), and Vascular Endothelial Growth Factor (VEGF)/receptor.
  • Synthesis of information regarding diagnosis and management strategies.

Main Results:

  • Targeted therapies targeting EGFR, HER2, BRAF, MAPK, ALK, PD-1/PD-L1, CTLA-4, and VEGF/receptor are associated with distinct patterns of renal toxicity.
  • Renal adverse events can range from acute kidney injury to chronic kidney disease, depending on the agent and duration of treatment.
  • The specific mechanisms of nephrotoxicity differ among these targeted agents.

Conclusions:

  • Clinicians must be vigilant for renal toxicities in patients receiving targeted anticancer therapies.
  • Early diagnosis and prompt management of renal adverse events are crucial for preserving kidney function and ensuring treatment continuity.
  • Understanding the specific nephrotoxic profiles of different targeted agents is essential for optimal patient care.
Keywords:
Acute interstitial nephritisAcute tubular necrosisGlomerulopathyGlomérulopathieInsuffisance rénaleIonic disturbanceNephrotoxicityNécrose tubulaire aiguëNéphrite interstitielle aiguëNéphrotoxicitéOnco-nephologyOnco-néphrologieRenal failureTargeted therapyThérapie cibléeTrouble ionique

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