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Abstract
Angiogenesis inhibitors such as tyrosine kinase inhibitors (TKIs) are common therapeutics currently used to treat oncologic disease. Surufatinib is a novel, small-molecule multiple receptor TKI approved by the National Medical Products Administration (NMPA) for the treatment of progressive, advanced, and well-differentiated pancreatic and extrapancreatic neuroendocrine tumours (NETs). Thrombotic microangiopathy (TMA) is a well-documented complication of TKIs targeting the VEGF-A/VEGFR2 signalling pathway. Here, we describe a 43-year-old female patient with biopsy-proven TMA and nephrotic syndrome due to surufatinib treatment for adenoid cystic carcinoma. Histological lesions included glomerular endothelial swelling, widening of subendothelial spaces, mesangiolysis, and double contour, which caused nephrotic proteinuria. Effective management was achieved by drug withdrawal and oral anti-hypertensive regents. The management of surufatinib-related nephrotoxicity without compromising its anticancer effects is challenging. Hypertension and proteinuria must be closely monitored during drug use to reduce or stop the dose in a timely manner before severe nephrotoxicity occurs.
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Details
1 Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Department of Endocrinology, Shanghai, China (GRID:grid.16821.3c) (ISNI:0000 0004 0368 8293)
2 Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Department of Neurosurgery, Shanghai, China (GRID:grid.16821.3c) (ISNI:0000 0004 0368 8293)
3 Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Department of Nephrology, Shanghai, China (GRID:grid.16821.3c) (ISNI:0000 0004 0368 8293)