Table 2.
Twelve detailed cases of AKI reported with vemurafenib
| Publication | Patient no. | Age/sex | Baseline GFR (mL/min/1.73 m2) and CKD stage | Clinical presentation | Renal outcome | Cancer outcome | Kidney biopsy performed |
|---|---|---|---|---|---|---|---|
| Regnier-Rosencher et al. [17] | 1 | 81/Male | 87 (CKD Stage 2) | 1–2 weeks following treatment, presented with AKI, microscopic hematuria, non-nephrotic range proteinuria and peripheral eosinophilia | Drug was stopped and AKI resolved. Reintroduction caused relapse of AKI | Complete response | No |
| Regnier-Rosencher et al. [17] | 2 | 86/Male | 50 (CKD Stage 3A) | 1–2 weeks after treatment, developed grade 3 skin eruption and AKI, hematuria, and non-nephrotic range proteinuria | Dose of drug was reduced to 75% of original dose and topical steroids given. Renal function improved but remained above baseline | Partial response | No |
| Regnier-Rosencher et al. [17] | 3 | 54/Male | 73 (CKD Stage 2) | 1 week after treatment, developed skin rash and AKI and non-nephrotic range proteinuria and peripheral eosinophilia | Drug was stopped, leading to improvement of skin and renal condition. Reintroduction 1 month later at a lower dose led to skin rash and AKI | Complete response | No |
| Regnier-Rosencher et al. [17] | 4 | 82/Male | 70 (CKD Stage 2) | 1–2 weeks after treatment, developed rash and AKI | Drug was stopped and that led to gradual improvement of rash and renal function | Complete response | No |
| Launay-Vacher et al. [18] | 5 | 71/Female | 57 (CKD Stage 3A) | One more after treatment, had AKI and rash. No proteinuria | Drug was reduced by 50% and renal function stabilized at a new baseline | No data provided | No |
| Launay-Vacher et al. [18] | 6 | 68/Male | 66 (CKD Stage 2) | 1 week following treatment, AKI was noted | After stopping agent, a kidney biopsy was done showing ATN with arteriosclerosis lesions. Drug with 75% reduced dose was reintroduced, but creatinine continued to rise and therapy was stopped. Patient would have required dialysis but chose not to. Patient expired | Progression of disease | Yes—ATN |
| Launay-Vacher et al. [18] | 7 | 80/Female | 50 (CKD Stage 3A) | After 2 months on treatment, developed AKI | Drug was maintained for 4 months and renal function gradually returned to baseline | No data provided | No |
| Launay-Vacher et al. [18] | 8 | 77/Male | 62 (CKD Stage 2) | 1 week after starting treatment, developed AKI with non-nephrotic range proteinuria and skin rash | Drug was maintained and renal function spontaneously improved and plateaued 3 weeks later | Progression of disease | No |
| Launay-Vacher et al. [18] | 9 | 63/Male | 88 (CKD Stage 2) | 1 week after starting treatment, developed AKI and non-nephrotic range proteinuria | Drug was continued at 75% of the dose and AKI did not improve. Eventually, drug was stopped and renal function improved. Reintroduction at 50% decreased dose still led to AKI, but then stabilized and remained stable on the drug | No data provided | No |
| Launay-Vacher et al. [18] | 10 | 41/Male | 83 (CKD Stage 2) | 2 weeks after treatment, developed AKI | Drug was stopped. When drug was reintroduced at 75% of the dose, renal function again worsened. Once stopped, renal function completely recovered | Disease progression | No |
| Launay-Vacher et al. [18] | 11 | 69/Male | 57 (CKD Stage 3A) | 1 month after treatment, developed AKI and photosensitivity | Drug was maintained and serum creatinine remained elevated. Once drug was changed to fotemustine, renal function rapidly improved | Disease progression | No |
| Launay-Vacher et al. [18] | 12 | 61/Male | 51 (CKD Stage 3A) | 1 month after treatment, developed AKI with hematuria and non-nephrotic range proteinuria | Drug was reduced to 75% dose and renal function eventually stabilized on the drug | Complete response | No |
AKI, acute kidney injury; CKD, chronic kidney disease; GFR, glomerular filtration rate; ATN, acute tubular necrosis.