Department of Endocrinology, Metabolism and Nephrology, Kochi Medical School, Japan.
Department of Gastroenterology and Hepatology, Kochi Medical School, Japan.
Intern Med. 2023 Jan 1;62(1):91-94. doi: 10.2169/internalmedicine.9425-22. Epub 2022 Jun 14.
Vascular endothelial growth factor inhibitors and checkpoint inhibitors are effective treatments for solid tumors. These new classes of anti-cancer agents frequently cause kidney-related side effects. Although their anti-cancer effects may be enhanced when used in combination, the severity of their kidney-related side effects is unknown. We herein report the first case of thrombotic microangiopathy and mesangial proliferative glomerulonephritis caused by combined treatment with atezolizumab and bevacizumab in a 74-year-old man with hepatocellular carcinoma. The combination therapy was discontinued and replaced with intravenous methylprednisolone followed by oral prednisolone. Subsequently, the urinary protein excretion levels declined.
血管内皮生长因子抑制剂和检查点抑制剂是治疗实体瘤的有效方法。这些新型抗癌药物常引起肾脏相关的副作用。虽然联合使用可能会增强其抗癌作用，但它们引起肾脏相关副作用的严重程度尚不清楚。本文报道了一例 74 岁男性肝细胞癌患者联合使用阿替利珠单抗和贝伐珠单抗引起血栓性微血管病和系膜增生性肾小球肾炎的病例。停用联合治疗，并改用静脉甲基泼尼松龙，然后口服泼尼松龙。随后，尿蛋白排泄水平下降。
