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Popular Cancer Drug can cause Kidney Damage
Newswise, June 2010 — The widely used cancer drug bevacizumab may
cause severe loss of protein from the kidney
into the urine that can lead to significant
kidney damage and can compromise the
efficacy of cancer treatment, according to a
study appearing in an upcoming issue of the
Journal of the American Society of
The results suggest that physicians should monitor
patients’ kidney health when prescribing
this angiogenesis inhibitor.
While research indicates that treatment with the
chemotherapy drug bevacizumab can lead to
urinary protein leakage (proteinuria) and
kidney damage, the overall risk associated
with the drug and patient risk factors are
unknown. Bevacizumab blocks a protein called
vascular endothelial growth factor, thus
inhibiting the production of new blood
vessels around tumors.
Shenhong Wu MD, PhD (Stony Brook University Cancer Center),
Xiaolei Zhu, MD, PhD (Kidney Doctors PLLC),
and their colleagues conducted a review of
published randomized, controlled clinical
trials to assess the overall risk for severe
proteinuria in patients taking bevacizumab.
The researchers analyzed data from 16
studies comprising 12,268 patients with a
variety of tumors.
Severe proteinuria occurred in 2.2% of patients taking
Compared with patients taking
chemotherapy alone, patients taking
bevacizumab combined with chemotherapy had a
4.79-fold increased risk of developing
severe proteinuria and a 7.78-fold increased
risk of developing nephrotic syndrome. (Nephrotic
syndrome is a group of symptoms including
protein in the urine, low blood protein
levels, high cholesterol levels, high
triglyceride levels, and swelling.)
Patients taking higher dosages of bevacizumab had the
greatest risk of developing proteinuria.
Also, when the investigators looked at
differences by cancer type, they found that
patients with kidney cancer had the highest
risk of developing proteinuria (10.2%
These results indicate that it is particularly important to
monitor the effects of bevacizumab in
patients who have kidney cancer or who are
receiving high doses of the drug. Future
studies should investigate how to reduce
bevacizumab’s kidney-related effects, and
physicians should be prepared to treat these
potential side effects.
Study co-authors include Christi Kim, MD and Lea Baer, MD
(Stony Brook University Cancer Center).
Disclosures: Dr. Wu received honoraria from Onyx
Pharmaceuticals, Novartis, and Wyeth, and
has been a speaker for Onyx, Pfizer Inc, and
Novartis. The other authors reported no
The article, entitled “Bevacizumab Increases Risk for
Severe Proteinuria in Cancer Patients,” will
appear online at
http://jasn.asnjournals.org/ on June 10,
The content of this article does not reflect the views or
opinions of The American Society of
Nephrology (ASN). Responsibility for the
information and views expressed therein lies
entirely with the author(s).
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Founded in 1966, the American Society of Nephrology (ASN)
is the world’s largest professional society
devoted to the study of kidney disease.
Comprised of 11,000 physicians and
scientists, ASN continues to promote expert
patient care, to advance medical research,
and to educate the renal community. ASN also
informs policymakers about issues of
importance to kidney doctors and their
ASN funds research, and through
its world-renowned meetings and first-class
publications, disseminates information and
educational tools that empower physicians.