Targeted cancer therapies (biologics)

Novel targeted anticancer therapies have resulted in improvement in patient survival compared with standard chemotherapy. Renal toxicities of targeted agents are increasingly being recognized. The incidence, severity, and pattern of renal toxicities may vary according to the respective target of the drug. In this chapter, we review the adverse renal effects associated with a selection of currently approved targeted cancer therapies, directed to epidermal growth factor receptor (EGFR), human epidermal growth factor receptor 2 (HER 2), v-RAF murine sarcoma viral oncogene homolog B (BRAF), mitogen-activated protein kinases (MEK), anaplastic lymphoma kinase (ALK), and agents targeted to vascular endothelial growth factor receptor (VEGF/R) and tyrosine kinase inhibitors (TKIs). In summary, electrolyte disorders, renal impairment and hypertension are the most commonly reported events. The early diagnosis and prompt recognition of these renal adverse events are essential for the general nephrologist taking care of these patients.