Chapter

Biological cancer therapies and the kidney

Vincent Launay-Vacher

in Cancer and the Kidney

Second edition

Published on behalf of Oxford University Press

Published in print November 2010 | ISBN: 9780199580194
Published online November 2012 | e-ISBN: 9780191753404 | DOI: http://dx.doi.org/10.1093/med/9780199580194.003.0006

Series: Oxford Clinical Nephrology Series

Biological cancer therapies and the kidney

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There are several kinds of biological therapies of cancer. The common characteristic of those drugs remains in their origin, which is biological rather than chemical. Among them can be found monoclonal antibodies and growth factors. Other drugs which share the same mechanisms of action are also commonly considered as biological therapies given that they share the same mechanism of action or have similar targets. This is the case for a number of tyrosine kinase inhibitors.

Monoclonal antibodies in the treatment of cancer include rituximab, which is directed towards the CD20 protein present at the surface of lymphocytes; bevacizumab, whose target is the vascular endothelial growth factor (VEGF); trastuzumab, which targets the human epidermal growth factor receptor 2 (HER–2); and cetuximab, which targets the epidermal growth factor receptor (eGFR). Several other monoclonal antibodies are currently under phase two or three studies such as panitumumab (EGFR), or pertuzumab (HER–2, with a different binding site on the receptor as compared to trastuzumab). In addition, erlotinib targets the eGFR and lapatinib the HER–2. Growth factors mainly include white blood cell growth factors such as filgrastim or red blood cell growth factors such as erythropoetins, alpha or beta. Numerous tyrosine kinase inhibitors (TKIs) have been or are currently developed in cancer. They act by inhibiting the intracellular tyrosine kinase of growth factor receptors. VEGF receptor TKIs include sunitinib, sorafenib, pazopanib, axitinib, mosetanib, and others that are under development.

This chapter focuses on the interactions of those biological therapies with the kidney. We focus on the effects of anti-VEGF drugs, both monoclonal antibodies and TKIs, since their mode of action on the VEGF pathway results in significant effects on blood vessels which may lead to renal and vascular side effects. Those side effects mainly manifest as arterial hypertension (HTN), proteinuria (Pu), and in some cases renal impairment (RI).

Chapter.  6005 words.  Illustrated.

Subjects: Nephrology ; Medical Oncology

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