Division of Medical Oncology, Department of Internal Medicine, Trakya University School of Medicine, 22030, Edirne, Turkey.
Department of Radiology, Trakya University School of Medicine, Edirne, Turkey.
Int J Clin Oncol. 2020 Oct;25(10):1757-1762. doi: 10.1007/s10147-020-01729-3. Epub 2020 Jun 26.
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.
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.
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.
CIN was significantly more frequent in cancer patients who receiving anti-VEGF/R drugs than those not receiving anti-VEGF/R drugs.
癌症患者的对比剂肾病风险一直在增加。用于肿瘤治疗的抗血管内皮生长因子/受体（anti-VEGF/R）药物也存在明显的肾毒性副作用。本研究旨在确定抗 VEGF/R 药物的使用与癌症患者对比剂肾病（CIN）的发展之间可能存在的关联。
本前瞻性横断面研究共纳入 92 例患者。排除肾小球滤过率（GFR）<50ml/min、血红蛋白<10g/dl、东部合作肿瘤组（ECOG）评分≥2 且接受过肾毒性药物的患者。在 CT 前、CT 后第 2、3 和 7 天采集血样。CIN 定义为血清肌酐值升高 0.5mg/dl 或较基线升高 25%。使用卡方检验比较接受和不接受抗 VEGF/R 治疗的患者的 CIN 发生率。还分析了贝伐单抗与其他抗 VEGF/R 药物的 CIN 发生率。
抗 VEGF/R（+）组 39 例，抗 VEGF/R（-）组 53 例。抗 VEGF/R（+）组 11 例（28%）和抗 VEGF/R（-）组 3 例（5.6%）发生 CIN（p=0.006）。在抗 VEGF/R（+）组中，23 例患者接受贝伐单抗（联合 FOLFOX/FOLFIRI）治疗，16 例患者接受其他抗 VEGF/R（舒尼替尼、阿昔替尼、瑞戈非尼、阿柏西普）有效治疗。接受贝伐单抗或其他抗 VEGFR 治疗的患者 CIN 发生率相似（p=0.63）。在这些患者中，有 1 例因急性肾损伤导致死亡。
与未接受抗 VEGF/R 药物治疗的癌症患者相比，接受抗 VEGF/R 药物治疗的癌症患者的 CIN 发生率显著更高。
