Renal effects of targeted anticancer therapies.
The use of novel targeted anticancer agents has led to overall improvement in the prognosis of many patients affected by various malignancies, but has also been associated with an increased risk of poorly characterized toxic effects to different organs, including the kidneys. The high prevalence of kidney impairment in the general population complicates the issue further. Nephrologists most frequently work with patients with cancer when they are asked to investigate kidney function to assess the need for dose adjustments in anticancer therapy. A thorough knowledge of the renal safety profile of novel life-prolonging anticancer therapies, specific features of their metabolism, and pharmacokinetic and pharmacodynamic properties (under normal circumstances as well as in the setting of renal replacement therapy) is, therefore, necessary to preserve kidney function as far as possible and to ensure optimum treatment. In this Review we summarize the present knowledge of renal toxic effects from novel targeted anticancer agents and discuss whether the management of patients' treatment needs to be modified. We also advocate the development of a new onconephrology subspeciality.
Medical Oncology, I.R.C.C.S. San Matteo University Hospital Foundation, Piazzale C. Golgi 19, 27100 Pavia, Italy.
Camillo
C
Porta
Nephrology and Dialysis, Istituti Ospitalieri Cremona, Largo Priori 1, 26100 Cremona, Italy.
Laura
L
Cosmai
Nephrology and Dialysis, San Carlo Borromeo Hospital, University of Milano, Via Pio II, 3, 20153 Milan, Italy.
Maurizio
M
Gallieni
Medical Oncology, I.R.C.C.S. San Matteo University Hospital Foundation, Piazzale C. Golgi 19, 27100 Pavia, Italy.
Paolo
P
Pedrazzoli
Nephrology and Dialysis, Istituti Ospitalieri Cremona, Largo Priori 1, 26100 Cremona, Italy.
Fabio
F
Malberti
D020533:Angiogenesis Inhibitors / Q000008:administration & dosage; D000818:Animals; D000970:Antineoplastic Agents / Q000008:administration & dosage* / Q000627:therapeutic use*; D000068258:Bevacizumab / Q000008:administration & dosage; D060908:CTLA-4 Antigen / Q000187:drug effects; D000068338:Everolimus / Q000494:pharmacology; D018773:Genes, erbB-1 / Q000187:drug effects; D006801:Humans; D007668:Kidney / Q000187:drug effects*; D007676:Kidney Failure, Chronic / Q000453:epidemiology; D007687:Kidney Tubules, Proximal / Q000187:drug effects; D058990:Molecular Targeted Therapy / Q000009:adverse effects*; D009369:Neoplasms / Q000188:drug therapy*; D040262:Receptors, Vascular Endothelial Growth Factor / Q000187:drug effects; D058570:TOR Serine-Threonine Kinases / Q000037:antagonists & inhibitors; D042461:Vascular Endothelial Growth Factor A / Q000187:drug effects
D020533:Angiogenesis Inhibitors; D000970:Antineoplastic Agents; D060908:CTLA-4 Antigen; C556706:CTLA4 protein, human; D042461:Vascular Endothelial Growth Factor A; D000068258:Bevacizumab; D000068338:Everolimus; C546842:MTOR protein, human; D040262:Receptors, Vascular Endothelial Growth Factor; D058570:TOR Serine-Threonine Kinases