Abstract: SA-PO1274
Vascular Endothelial Growth Factor Inhibitors May Not Need to Be Stopped After New-Onset Proteinuria in Patients with Cancer
Session Information
- Onconephrology: Epidemiological Trends, Risk Stratification, and Clinical Outcomes
October 24, 2026 | Location: Exhibit Hall A, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Onconephrology
- 1600 Onconephrology
Authors
- Baghaeivaji, Farnaz, UH Cleveland Medical Center, Cleveland, Ohio, United States
- Hammad, Nour, Wayne State University, Detroit, Michigan, United States
- Fardi, Yasameen, UH Cleveland Medical Center, Cleveland, Ohio, United States
- Rashidi, Arash, UH Cleveland Medical Center, Cleveland, Ohio, United States
Background
Vascular endothelial growth factor (VEGF) inhibitors are well recognized to cause proteinuria. Although dose interruption or discontinuation is often practiced, there remains no standardized evidence-based strategy on how to manage or prevent VEGFi-induced proteinuria.
Methods
We conducted a retrospective cohort study of 103 adult patients who were treated with bevacizumab in our institution. We examined the incidence of proteinuria and AKI in patients who were treated with bevacuzimab. Proteinuria was defined as spot urine protein to creatinine ration more than 200 mg/g. AKI was defined based on KDIGO criteria. Patients with new onset or worsening proteinuria were categorized into two groups: patients who received subsequent doses despite proteinuria and patients in whom bevacizumab was stopped after proteinuria onset.
Results
Overall, 32 patients developed either new onset proteinuria or increased proteinuria (31.1%). Twenty-two patients who developed new onset or had worse proteinuria continued their treatment and 9 patients discontinued their treatment. One patient with missing data was excluded. The piecewise Based on logistic regression analyses, we found no evidence of a difference in the odds of AKI between patients who continued versus discontinued bevacuzimab after developing proteinuria (OR=0.56, 95% CI: 0.12, 2.54; P=0.45).
Conclusion
Proteinuria and AKI are common in patients receiving anti-VEGF therapy. In this cohort, discontinuation of therapy after proteinuria onset was not associated with improved survival or renal outcomes, suggesting that continuation of therapy with careful monitoring may be appropriate in selected patients.
Effect of Discontinued anti-VEGF Therapy Status and Overall Survival: Piecewise Cox Models.
| Holding status (discontinued vs. continued) | HR (95% CI) | P |
| When Survival time ≤ 9.84m | 0 (0,NA) | 0.99 |
| When Survival time > 9.84m | 1.97 (0.57, 6.78) | 0.28 |
Proteinuria pts (n=31)