Renal toxicity of anticancer agents targeting HER2 and EGFR.
EGFR and HER2 are found overexpressed and/or activated in many different human malignancies (e.g. breast and colon cancer), and a number of drugs specifically targeting these two tyrosine kinases have been developed over the years as anticancer agents. In the present review, the renal safety profile of presently available agents targeting either HER2 or EGFR will be discussed, together with the peculiarities related to their clinical use in patients with impaired renal function, or even in dialysis. Indeed, even though renal toxicity is not so common with these agents, it may nevertheless happen, especially when these agents are combined with traditional chemotherapeutic agents. As a whole, kidney impairment or dialysis should not be regarded per se as reasons not to administer or to stop an active anti-HER or anti-EGFR anticancer treatment, especially given the possibility of significantly improving the life expectancy of many cancer patients with the use of these agents.
Division of Nephrology and Dialysis, Istituti Ospitalieri di Cremona, Largo Priori, 1, 26100, Cremona, Italy. lacos@iol.it.|Italian Association of Medical Oncology (AIOM), Milan, Italy. lacos@iol.it.|Italian Society of Nephrology (SIN) Working Group on Onco-Nephrology, Bologna, Italy. lacos@iol.it.
Laura
L
Cosmai
Nephrology and Dialysis, San Carlo Borromeo Hospital, Milan, Italy.|Italian Association of Medical Oncology (AIOM), Milan, Italy.|Italian Society of Nephrology (SIN) Working Group on Onco-Nephrology, Bologna, Italy.
Maurizio
M
Gallieni
Medical Oncology, I.R.C.C.S. San Matteo University Hospital Foundation, Pavia, Italy. c.porta@smatteo.pv.it.|Italian Association of Medical Oncology (AIOM), Milan, Italy. c.porta@smatteo.pv.it.|Italian Society of Nephrology (SIN) Working Group on Onco-Nephrology, Bologna, Italy. c.porta@smatteo.pv.it.
Camillo
C
Porta
D058186:Acute Kidney Injury / Q000139:chemically induced*; D000080044:Ado-Trastuzumab Emtansine; D000077716:Afatinib; D061067:Antibodies, Monoclonal, Humanized / Q000009:adverse effects; D000970:Antineoplastic Agents / Q000009:adverse effects* / Q000494:pharmacology; D000068818:Cetuximab / Q000009:adverse effects; D066246:ErbB Receptors / Q000037:antagonists & inhibitors*; D000069347:Erlotinib Hydrochloride / Q000009:adverse effects; D000077156:Gefitinib; D006801:Humans; D000077341:Lapatinib; D008453:Maytansine / Q000009:adverse effects / Q000031:analogs & derivatives; D009369:Neoplasms / Q000188:drug therapy*; D047428:Protein Kinase Inhibitors / Q000009:adverse effects* / Q000494:pharmacology; D011799:Quinazolines / Q000009:adverse effects; D018719:Erb-b2 Receptor Tyrosine Kinases / Q000037:antagonists & inhibitors*; D006435:Renal Dialysis; D051436:Renal Insufficiency, Chronic / Q000628:therapy; D000068878:Trastuzumab / Q000009:adverse effects
D000080044:Ado-Trastuzumab Emtansine; D000077716:Afatinib; D061067:Antibodies, Monoclonal, Humanized; D000970:Antineoplastic Agents; D000068818:Cetuximab; D066246:ErbB Receptors; D000069347:Erlotinib Hydrochloride; D000077156:Gefitinib; D000077341:Lapatinib; D008453:Maytansine; D047428:Protein Kinase Inhibitors; D011799:Quinazolines; D018719:Erb-b2 Receptor Tyrosine Kinases; D000068878:Trastuzumab; C508053:ERBB2 protein, human; C485206:pertuzumab
Dialysis; EGFR inhibitors; HER2-targeting agents; Kidney impairment; Kidney toxicity