Clinical features, diagnosis, and management of dasatinib-induced nephrotic syndrome

Area of Science:

• Nephrology
• Oncology
• Pharmacology

Background:

• Dasatinib is a tyrosine kinase inhibitor used in cancer treatment.
• Nephrotic syndrome is a kidney disorder characterized by heavy protein in the urine.
• Clinical features of dasatinib-induced nephrotic syndrome are not well-established, with knowledge primarily from case reports.

Purpose of the Study:

• To investigate and describe the clinical characteristics of nephrotic syndrome induced by dasatinib.

Main Methods:

• A retrospective analysis of case reports from 25 patients who developed nephrotic syndrome while on dasatinib therapy.
• Clinical data, including onset, symptoms, laboratory values (serum albumin, 24-hour urine protein), and kidney biopsy findings, were collected and analyzed.

Main Results:

• Nephrotic syndrome onset varied from 10 days to 5 years after starting dasatinib.
• Common symptoms included periorbital and lower-extremity edema.
• Kidney biopsies revealed findings such as focal foot process effacement and focal segmental glomerulosclerosis.
• Proteinuria resolved or improved upon dasatinib discontinuation, dose reduction, or switching to other tyrosine kinase inhibitors (TKIs).

Conclusions:

• Dasatinib can induce nephrotic syndrome with identifiable clinical and pathological features.
• Management involves modifying dasatinib treatment, leading to resolution or improvement of proteinuria.