349P - Proteinuria in patients treated with ramcirumab increases the risk of renal dysfunction

Background

It is unknown whether proteinuria caused by ramcirumab (RAM) induces renal dysfunction. Thus, this study assessed the relationship between proteinuria and other factors with RAM therapy, and compared estimated glomerular filtration rate (eGFR) with or without proteinuria in long-term treatment.

Methods

Medical records were retrospectively reviewed for 156 patients treated with chemotherapy that included RAM between April 1, 2015 and May 31, 2019 at Kure Medical Center. Forty-eight patients with a performance status of 3 or 4, or not measured for proteinuria among those treated with RAM, or has detected proteinuria before first commencing RAM administration were excluded. Proteinuria and eGFR were measured before treatment with RAM, and compared to minimum eGFR with or without proteinuria after treatment with RAM. The proteinuria group was defined as proteinuria detected at more than 1+ at least once.

Results

Overall, a total of 108 patients were included in this analysis. Thirty-nine patients were classified into a proteinuria group and the remaining 69 patients were classified into the non-proteinuria group. Age, sex, and eGFR before treatment with RAM did not significantly differ between the proteinuria group and non-proteinuria group. There were significant decreases in proteinuria group mean eGFR(-26.7±5.6 ml/min/1.73 m3), which was greater than the non-proteinuria group mean eGFR(-15.0±4.2 ml/min/1.73 m3), compared to eGFR before treatment (p<0.05). The incidence of grade 3 or 4 chronic kidney disease (CKD) was observed in 8 patients (20.5%) in the proteinuria group, but in only 3 patients (4.5%) in the non-proteinuria group (p<0.05). Patients treated over 200 days with RAM had a significant incidence of proteinuria, and in the proteinuria group, the appearance of proteinuria within 28 days from first administration decreased eGFR more than after 28 days.

Conclusions

Proteinuria caused by RAM might be decreased in eGFR, particularly in cases that immediately detected. Renal dysfunction can affect subsequent chemotherapy, and as such, it is important to regularly check proteinuria during treatment with RAM. It is necessary to take particular care for cases in which proteinuria is detected and renal function has already declined.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

The authors.

Funding

Has not received any funding.

Disclosure

All authors have declared no conflicts of interest.