Hypertonie und renale thrombotische Mikroangiopathie unter anti-angiogener Tumortherapie: Neue nephrologische Entitäten

Translated title of the contribution: Hypertension and renal thrombotic microangiopathy under anti-angiogenic tumor therapy: New nephrological entities

I. Grgic, A. Burchert, B. D. Humphreys

Research output: Contribution to journalArticlepeer-review

2 Scopus citations

Abstract

Anti-angiogenic therapies (AAT) targeting the VEGF signaling pathway (VSP) are increasingly used by oncologists for palliative treatment of patients with various solid tumors. While these non-curative drugs may improve certain treatment endpoints in selected cancer entities, clinical data suggest that they also cause a number of serious cardiovascular and renal side effects at rather high rates. For instance, the incidence of clinical hypertension has been estimated to be 19-24% and may be even higher with more potent second-generation VSP inhibitors. Onset of proteinuria has been observed in up to 20% of treated cases. Another frequently occurring renal complication under AAT is the development of renal thrombotic microangiopathy (TMA). This pattern of injury is the same as found in patients with pre-eclampsia, also a disease of disordered VEGF signaling and endothelial dysfunction. Because use of these medications continues to grow and many new formulations in development, there is an increasing need for the nephrologist to learn how to diagnose and manage VSP inhibitor toxicities. But at the same time there is a great opportunity to try connect these adverse events and clinical phenotypes back to the molecular mechanisms precipitating them. Consistent with the concept of personalized medicine, we may at some point use this new knowledge to individualize and hence optimize therapies for patients undergoing anti-angiogenic treatment.

Translated title of the contributionHypertension and renal thrombotic microangiopathy under anti-angiogenic tumor therapy: New nephrological entities
Original languageGerman
Pages (from-to)20-27
Number of pages8
JournalNephrologe
Volume11
Issue number1
DOIs
StatePublished - Jan 1 2016

Keywords

  • Anti-angiogenic therapy
  • Arterial hypertension
  • Proteinuria
  • Renal thrombotic microangiopathy
  • VEGF signaling pathway

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