Nephrotoxicity induced by VEGF-target agents in patients with metastatic renal cell cancer.

432 Background: A study was undertaken to investigate the association between treatment with vascular endothelial growth factor (VEGF)-targeted therapy for metastatic renal cell cancer (mRCC) and nephrotoxicity. Methods: Retrospective data were collected for mRCC patients received VEGF-targeted therapy between January 2005 and December 2010. We investigated renal adverse events and clinically significant increased serum creatinine level in patients who received VEGF target therapy. GFR was estimated with the Modification of Diet in Renal Disease (MDRD) formula. Results: Ninety one patients with mRCC who received sunitinib (n=46), sorafenib (n=38), axitnib (n=9) were included in this analysis. As for renal adverse events, acute renal failure occurred in 1 (2.2%) of 46 sunitinib recipients. Facial edema occurred 17 (37.0%) in sunitinib recipients, 2 (5.3%) of sorafenib recipients, 2 (22.2%) of axitinib recipients. In sunitinib recipients, all of these adverse events observed in ‘off’ period. During administration, gradual and significant increase of serum creatinine was observed in sunitinib recipients compared for sorafenib or axitinib recipients (p= 0.04). Significant decrease of GFR compared for baseline correlated with increase of serum creatinine level developed in ‘on’ period of 6 sunitinib administration cycle (p=0.013), but returned to baseline level after 2weeks cessation. No significant change was observed in serum creatinine level and GFR in patients received other VEGF-target agents. Conclusions: Our data suggest that nephrotoxicity developed in a high percentage of patients on sunitinib compared for sorafenib and axitinib in mRCC patients. Clinicians should observe renal function of sunitinib recipients more carefully in ‘off’ period as well as ‘on’ period.