Shibutani Yuma, Hayakawa Miki, Ishizaka Mayu
Department of Pharmacy, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa, 277-8577, Chiba, Japan.
Cancer Chemother Pharmacol. 2025 Jul 2;95(1):69. doi: 10.1007/s00280-025-04793-6.
Vascular endothelial growth factor (VEGF) inhibitors are associated with a high incidence of proteinuria. In patients with diabetes, increased proteinuria is closely associated with decreased renal function; however, the impact of increased proteinuria on renal function in patients with cancer and diabetes mellitus undergoing VEGF inhibitor therapy remains unknown.
The incidence of proteinuria and renal function in patients with cancer and a history of diabetes who were treated with VEGF inhibitors at the National Cancer Center Hospital East between January 2018 and December 2019 was retrospectively investigated.
Among the 49 patients included, 21 (43%) developed proteinuria ≥ 3 + after VEGF inhibitor treatment. In all patients, a decreasing trend in the estimated glomerular filtration rate (eGFR) was observed beginning 2 years after treatment initiation. The decrease in eGFR from baseline was - 6.6% at 1 year, -11% at 2 years, and - 13% at 4 years. Patients who developed proteinuria ≤ 2 + showed no significant decrease in eGFR from baseline to either the end of treatment (p = 0.91) or the latest value during the observation period (p = 0.64). Similarly, no significant decrease in eGFR was observed in those with proteinuria ≥ 3+ (end of treatment, p = 0.91; latest value during the observation period, p = 0.18).
In patients with cancer and diabetes mellitus, increased proteinuria after VEGF inhibitor therapy suggested that it was not associated with a significant decline in renal function.
血管内皮生长因子（VEGF）抑制剂与蛋白尿的高发生率相关。在糖尿病患者中，蛋白尿增加与肾功能下降密切相关；然而，在接受VEGF抑制剂治疗的癌症合并糖尿病患者中，蛋白尿增加对肾功能的影响尚不清楚。
回顾性调查2018年1月至2019年12月在国立癌症中心东医院接受VEGF抑制剂治疗的有糖尿病病史的癌症患者的蛋白尿发生率和肾功能。
在纳入的49例患者中，21例（43%）在VEGF抑制剂治疗后出现蛋白尿≥3+。在所有患者中，从治疗开始2年后观察到估计肾小球滤过率（eGFR）呈下降趋势。eGFR较基线的下降在1年时为-6.6%，2年时为-11%，4年时为-13%。出现蛋白尿≤2+的患者从基线到治疗结束（p=0.91）或观察期内的最新值（p=0.64），eGFR均无显著下降。同样，蛋白尿≥3+的患者eGFR也无显著下降（治疗结束时，p=0.91；观察期内的最新值，p=0.18）。
在癌症合并糖尿病患者中，VEGF抑制剂治疗后蛋白尿增加表明其与肾功能的显著下降无关。
