PMID- 30574461
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20201001
IS  - 2235-0640 (Print)
IS  - 2235-0802 (Electronic)
IS  - 2235-0640 (Linking)
VI  - 7
IP  - 6
DP  - 2018 Nov
TI  - Anti VEGF-TKI Treatment and New Renal Adverse Events Not Reported in Phase III 
      Trials.
PG  - 308-312
LID - 10.1159/000491387 [doi]
AB  - Cabozantinib and lenvatinib have been approved for the treatment of progressive 
      medullary thyroid cancer and radioiodine-resistant thyroid cancer, respectively. 
      Both phase III trials of cabozantinib and lenvatinib reported that renal adverse 
      events (AEs) rarely occurred. The cabozantinib phase III study reported no AEs 
      related to renal toxicity. In the lenvatinib phase III trial grade 3 (CTCAE), 
      proteinuria (urinary protein >/=3.5 g/24 h) was found in 10.0% of the lenvatinib 
      and 0.0% of the placebo patients. We report a 23-year-old patient with metastatic 
      medullary thyroid cancer who was enrolled in the phase III trial, comparing 
      cabozantinib to placebo and a 67-year-old patient with metastatic, papillary 
      thyroid carcinoma who was undergoing treatment with lenvatinib during his 
      enrollment in the phase III trial. The first patient had a normal kidney function 
      initially, but developed end-stage chronic kidney disease unexpectedly on 
      cabozantinib and additional zoledronate infusion. Whereas the second patient 
      suffered from a dramatic aggravation of his known mild chronic renal 
      insufficiency (KDOQI stage 2) due to long standing hypertension and 
      atherosclerosis during the treatment with lenvatinib. These severe AEs due to 
      anti-VEGF tyrosine kinase inhibitor treatment were unknown so far. In conclusion, 
      these 2 cases argue for increased awareness for the possibility of renal failure 
      as a consequence of anti-VEFG treatment. Predisposing conditions like known mild 
      chronic renal insufficiency with only mild proteinuria and with atherosclerosis 
      or precipitating co-medications like zoledronate infusion need to be accounted 
      for to prevent these severe AEs.
FAU - Paschke, Luisa
AU  - Paschke L
AD  - Department of Endocrinology and Nephrology, Division of Endocrinology, University 
      Clinic Leipzig, Leipzig, Germany.
AD  - Department of Endocrinology and Nephrology, Division of Nephrology, University 
      Clinic Leipzig, Leipzig, Germany.
FAU - Lincke, Thomas
AU  - Lincke T
AD  - Department of Radiology, Division of Nuclear Medicine, University Clinic Leipzig, 
      Leipzig, Germany.
FAU - Muhlberg, Katja Sibylle
AU  - Muhlberg KS
AD  - Department of Angiology, University Clinic Leipzig, Leipzig, Germany.
FAU - Jabs, Wolfram J
AU  - Jabs WJ
AD  - Department of Nephrology, Vivantes Clinics, Berlin, Germany.
FAU - Lindner, Tom H
AU  - Lindner TH
AD  - Department of Endocrinology and Nephrology, Division of Nephrology, University 
      Clinic Leipzig, Leipzig, Germany.
FAU - Paschke, Ralf
AU  - Paschke R
AD  - Division of Endocrinology, University of Calgary, Calgary, Alberta, Canada.
LA  - eng
PT  - Journal Article
DEP - 20180816
PL  - England
TA  - Eur Thyroid J
JT  - European thyroid journal
JID - 101604579
PMC - PMC6276742
OTO - NOTNLM
OT  - Cabozantinib
OT  - Chronic kidney failure
OT  - Differentiated thyroid cancer
OT  - Lenvatinib
OT  - Medullary thyroid cancer
OT  - Renal adverse events
OT  - Tyrosine kinase inhibitor
EDAT- 2018/12/24 06:00
MHDA- 2018/12/24 06:01
PMCR- 2019/05/01
CRDT- 2018/12/22 06:00
PHST- 2017/11/14 00:00 [received]
PHST- 2018/06/04 00:00 [revised]
PHST- 2018/12/22 06:00 [entrez]
PHST- 2018/12/24 06:00 [pubmed]
PHST- 2018/12/24 06:01 [medline]
PHST- 2019/05/01 00:00 [pmc-release]
AID - etj-0007-0308 [pii]
AID - 10.1159/000491387 [doi]
PST - ppublish
SO  - Eur Thyroid J. 2018 Nov;7(6):308-312. doi: 10.1159/000491387. Epub 2018 Aug 16.