475P - Renal toxicities in the era of molecularly targeted agents (MTAs)

Date 27 September 2014
Event ESMO 2014
Session Poster Display session
Topics Anti-Cancer Agents & Biologic Therapy
Complications of Treatment
Presenter Irene Brana Garcia
Citation Annals of Oncology (2014) 25 (suppl_4): iv146-iv164. 10.1093/annonc/mdu331
Authors I. Brana Garcia1, S. Sahebjam1, F. Quittnat2, E. Amir3, A.R.A. Razak1
  • 1Drug Development Program, Division Of Medical Oncology And Hematology, Princess Margaret Cancer Centre, M5T 2M9 - Toronto/CA
  • 2Department Of Internal Medicine - Division Of Nephrology, University Health Network - University of Toronto, M5G 2C4 - Toronto/CA
  • 3Division Of Medical Oncology And Hematology, Princess Margaret Cancer Centre, M5T 2M9 - Toronto/CA

Abstract

Aim

MTAs have been associated with a new spectrum of toxicities. Renal toxicities are known to be associated with some MTAs, but there are limited data on the frequency and characteristics of these toxicities. Here we evaluate the frequency of MTAs-induced renal toxicity reported in the literature. Additionally we explored other factors associated with the proportion of renal toxicity described.

Methods

We conducted a systematic review using MEDLINE and EMBASE to identify all articles published by December 2012 describing original data on renal toxicities induced by single-agent MTAs. Eligibility assessment and data collection were performed by 3 reviewers. Descriptive statistics were used to describe the toxicity characteristics. One-way ANOVA was performed to assess differences between different groups.

Results

10415 articles were reviewed and 145 met eligibility criteria. The median sample size was 26 (range 1-4917). 61.2 % of studies were clinical trials, 22.7% were case reports/series and the remainder were cohort studies. 242 independent renal toxicities were reported in these studies and data on frequency of renal toxicity were available for 170 different events. Signal transduction inhibitors (44.6%) and immunotherapies (35.1%) were the most commonly studied agents. The mean incidence for any renal toxicity was 19.6%. Of these, 42.6% were electrolyte disturbances, 32.2% were alteration of kidney function, 13.2% were proteinuric renal disease with the remaining 12% comprising other renal toxicity events such as hematuria or acute nephritis. Statistically significant differences in the frequency of the renal toxicity were observed based on the drug class and study type (Table 1).

Drug class
Receptor or Signal Transduction 14.9% p = 0.05
Immunotherapy 26.5%
Epigenetic 18.5%
Antiangiogenic 25.0%
Cell cycle 19.6%
Study Type
Clinical Trial 17.9 % p < 0.001
Case Report/Series 15.5%
Prospective cohort 45.9 %
Retrospective cohort 36.7 %
Review 6.7 %
Meta-analysis 19.6 %

Conclusions

The occurrence of MTAs associated renal toxicities is almost 20%. Certain drug classes, such as antiangiogenics and immunotherapies are associated with higher frequency of renal adverse events. Studies specifically designed to characterize these toxicities such as cohort studies seem to observe higher frequency of MTAs-induced renal toxicities, perhaps due to selection bias.

Disclosure

All authors have declared no conflicts of interest.