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

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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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Funding

There are no funding sources in this study.

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Authors and Affiliations

  1. Division of Medical Oncology, Department of Internal Medicine, Trakya University School of Medicine, 22030, Edirne, Turkey

    Ali Gökyer, Ahmet Küçükarda, Osman Köstek, Muhammet Bekir Hacıoğlu, Sernaz Uzunoğlu, Bülent Erdoğan & İrfan Çiçin

  2. Department of Radiology, Trakya University School of Medicine, Edirne, Turkey

    Osman Kula & Nazmi Kurt

  3. Division of Nephrology, Department of Internal Medicine, Trakya University School of Medicine, Edirne, Turkey

    Sedat Üstündağ

Authors
  1. Ali Gökyer
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  2. Ahmet Küçükarda
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  10. İrfan Çiçin
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Correspondence to Ali Gökyer.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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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 25, 1757–1762 (2020). https://doi.org/10.1007/s10147-020-01729-3

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  • DOI: https://doi.org/10.1007/s10147-020-01729-3

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