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Biological Cancer Therapies and the Kidney

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Onconephrology

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Abstract

Targeted therapies now cover a range of new signaling cascades. Because these drugs are both specific and highly potent, toxicities are now a well-recognized consequence of these therapies. Typically, these toxicities result from inhibition of the biologic pathway in a non-cancer tissue, where the pathway regulates some aspect of organ homeostasis. Kidney toxicities are often cumulative, and high dose or prolonged therapy increases the risk of renal dysfunction. Whereas acute kidney injury generally improves when diagnosed early, there is a very real risk of permanent chronic kidney disease (CKD) due to chemotherapy. Nephrologists need to be aware of the presentation, prevention, and treatment of toxicities associated with targeted therapies. This chapter will review the kidney toxicities of antiangiogenic therapies, of epidermal growth factor receptor (EGFR) inhibitors, and of other multi-targeted tyrosine kinase inhibitors (TKI).

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Abbreviations

ABPM:

Ambulatory blood pressure monitor

AKI:

Acute kidney injury

CKD:

Chronic kidney disease

CML:

Chronic myelogenous leukemia

EC:

Endothelial cells

EGFR:

Epidermal growth factor receptor

eNOS:

Endothelial nitric oxide synthase

ET:

Endothelin

GFR:

Glomerular filtration rate

GIST:

Gastrointestinal stromal tumor

NO:

Nitric oxide

TKI:

Tyrosine kinase inhibitors

TMA:

Thrombotic microangiopathy

VEGF:

Vascular endothelial growth factor

VEGFR:

Vascular endothelial growth factor receptor

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Authors and Affiliations

  1. Department of Medicine, Brigham and Women’s Hospital, Harvard Institutes of Medicine Rm 550, 4 Blackfan Circle, 02115, Boston, MA, USA

    Benjamin D. Humphreys M.D., Ph.D.

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  1. Benjamin D. Humphreys M.D., Ph.D.
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Correspondence to Benjamin D. Humphreys M.D., Ph.D. .

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Editors and Affiliations

  1. Department of Medicine, Division of Kidney Diseases and Hypertension, North Shore University Hospital and Long Island Jewish Medical Center, Hofstra North Shore LIJ School of Medicine, Great Neck, New York, USA

    Kenar D. Jhaveri

  2. Nephrology Section, General Internal Medicine, University of Texas MD Anderson Cancer Center, Houston, Texas, USA

    Abdulla K. Salahudeen

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Humphreys, B. (2015). Biological Cancer Therapies and the Kidney. In: Jhaveri, K., Salahudeen, A. (eds) Onconephrology. Springer, New York, NY. https://doi.org/10.1007/978-1-4939-2659-6_5

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  • DOI: https://doi.org/10.1007/978-1-4939-2659-6_5

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