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Renal tolerance of targeted therapies


Bulletin du Cancer. Volume 99, Number 3, 317-22, Mars 2012, Synthèse

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Author(s) : Juliette Thariat, Nicolas Janus, Jérôme Barrière, Vincent Launay-Vacher

Summary : The use of targeted therapies is increasing in the treatment of cancer. Monoclonal antibodies and tyrosine kinase inhibitors are the most commonly used but other classes such as mTOR inhibitors are increasingly prescribed. These treatments are often given in the long term in metastatic and maintenance treatments. It is therefore important to monitor the occurrence of immediate toxicities but also later and cumulative toxicities. Renal toxicities of targeted therapies are most often due to structural damages of the nephron. The anti-epidermal growth factor receptor (EGFR) and anti-vascular endothelial growth factor receptor (VEGFR) have renal side effects since growth factor receptors are expressed in the kidney. The toxicity of molecules such as bortezomib, erlotinib and lapatinib are less known. The approvals by the Food and Drugs Administration (FDA) and European Medicines Agency (EMA) of sorafenib, sunitinib and temsirolimus were based on studies of less than 3 000 patients. In this context, there is little data on their acute and chronic tolerance, including on the kidneys. This short review synthesizes the physiopathological hypotheses, early diagnosis and treatment of renal toxicity of major targeted therapies available in 2011.

Keywords : targeted therapies, renal toxicity, acute, cumulative, maintenance

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