Evaluation of Proteinuria Using Urine Protein : Creatine Ratio in Treatment with Molecular Targeted Agents for Advanced Renal Cell Carcinoma

The usefulness of the urine protein : creatine ratio (UPCR) in management of molecular targeted therapy and immunotherapy has not been studied, although urine protein dipstick testing (uPr) is widely used in the clinical setting. The aim of this study was to investigate the usefulness of UPCR as com...

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Bibliographic Details
Published in:Biological & pharmaceutical bulletin 2020/10/01, Vol.43(10), pp.1506-1510
Main Authors: Nakamura, Katsuyuki, Tanaka, Toshiaki, Masumori, Naoya, Miyamoto, Atsushi, Hirano, Takeshi
Format: Article
Language:English
Subjects:
Creatine
Immunotherapy
Kidney cancer
Kinases
molecular targeted drug therapy
Monoclonal antibodies
Patients
Protein-tyrosine kinase
Proteins
Proteinuria
Renal cell carcinoma
Targeted cancer therapy
Urine
urine protein : creatine ratio
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Summary:The usefulness of the urine protein : creatine ratio (UPCR) in management of molecular targeted therapy and immunotherapy has not been studied, although urine protein dipstick testing (uPr) is widely used in the clinical setting. The aim of this study was to investigate the usefulness of UPCR as compared to uPr in patients undergoing molecular targeted therapy for advanced renal cell carcinoma (RCC). A total of 25 patients (median age 68 years) with advanced RCC were included. Sunitinib, pazopanib, axitinib, sorefenib, everolimus, and nivolumab were administered to 15, 9, 16, 3, 7, and 13 patients, respectively, with duplication. Proteinuria was managed according to the grade determined by UPCR. Data at every treatment visit were retrospectively collected and uPr and UPCR were compared. The overall incidences of any grade of proteinuria associated with sunitinib, pazopanib, axitinib, sorafenib and everolimus were 86.7, 88.9, 93.8, 100, and 85.7%, respectively. There were discordances between the uPr-based grade and UPCR-based grade. UPCR did not meet the criteria of Grade 3 in 70.6, 100, 83.3, and 83.3% at visits in cases with uPr 3+ for sunitinib, pazopanib, sorafenib, and everolimus, respectively. In axitinib treatment, UPCR did not meet the criteria for withholding in 46.2% of the cases of uPr 2+ and more. Our study suggests that UPCR may be useful tool in management of adverse events associated with tyrosine kinase inhibitors, everolimus and can provide patients with optimal opportunities for receiving treatment.
ISSN:0918-6158
1347-5215
DOI:10.1248/bpb.b20-00256