Renal toxicity of anticancer agents targeting vascular endothelial growth factor (VEGF) and its receptors (VEGFRs)

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.

Journal of nephrology. 2016 May 06 [Epub ahead of print]

Laura Cosmai, Maurizio Gallieni, Wanda Liguigli, Camillo Porta

Division of Nephrology and Dialysis, Ambulatory of Onco-Nephrology, Istituti Ospitalieri Cremona, Largo Priori, 1, 26100, Cremona, Italy. ., Nephrology and Dialysis, San Carlo Borromeo Hospital, Milan, Italy., Medical Oncology, Istituti Ospitalieri di Cremona, Cremona, Italy., Medical Oncology, I.R.C.C.S. San Matteo University Hospital Foundation, Pavia, Italy.