Contrast nephropathy in cancer patients receiving anti-VEGF therapy: a prospective study

Abstract

Objectives

Contrast nephropathy risk has been increasing in cancer patients. Nephrotoxic side effects of anti-vascular endothelial growth factor/receptor (anti-VEGF/R) drugs used in oncologic treatment are also prominent. The purpose of this study was to identify the possible association among anti-VEGF/R drugs use and development of the contrast-induced nephropathy (CIN) in patients with cancers.

Methods

A total of 92 patients were included in this prospective cross-sectional study. Patients whose glomerular filtration rate (GFR) of < 50 ml/min, hemoglobin of < 10 g/dl, and eastern cooperative oncology group (ECOG) score of ≥ 2 and had received nephrotoxic drugs were not included in the study. Blood samples were collected baseline at pre computed tomography (CT) and day 2, day 3 and day 7 later CT imaging. CIN was defined as either an increased serum creatinine value of 0.5 mg/dl or increased 25% to baseline. CIN frequency between groups receivingand not receiving anti-VEGF/R was compared using the chi-squared test. CIN frequency between bevacizumab and other anti-VEGF/R was also analyzed.

Results

There were 39 patients in the anti-VEGF/R (+) group and 53 patients in the anti-VEGF/R (−) group. Eleven patients (28%) in the anti-VEGF/R (+) group and 3 patients (5.6%) in the anti-VEGF/R (−) group had CIN (p = 0.006). In the anti-VEGF/R (+) group, 23 patients received bevacizumab (combined with FOLFOX/FOLFIRI), while 16 patients received other anti-VEGF/R (sunitinib, axitinib, regorafenib, aflibercept) effective treatments. CIN ratio in patients who received bevacizumab or other anti-VEGFR therapy was similar (p = 0 = 50). Of the patients, one patient had acute kidney injury leading to death.

Conclusion

CIN was significantly more frequent in cancer patients who receiving anti-VEGF/R drugs than those not receiving anti-VEGF/R drugs.

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Abbreviations

VEGF:

Vasculer endothelial growth factor

CT:

Computed tomography

CIN:

Contrast-induced nephropathy

GFR:

Glomerular filtration rate

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Correspondence to Ali Gökyer.

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Gökyer, A., Küçükarda, A., Köstek, O. et al. Contrast nephropathy in cancer patients receiving anti-VEGF therapy: a prospective study. Int J Clin Oncol (2020). https://doi.org/10.1007/s10147-020-01729-3

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Keywords

  • Contrast media
  • Anticancer agents
  • Spiral CT scan