Nephrotic syndrome induced by cetuximab in a patient with metastatic colorectal cancer

J Oncol Pharm Pract. 2022 Jun;28(4):998-1002. doi: 10.1177/10781552211073790. Epub 2022 Jan 13.

Abstract

Introduction: Cetuximab, an anti-EGFR monoclonal antibody, often cause skin toxicity, most commonly acneiform rash. We present a rare case of glomerulonephritis associated with cetuximab therapy.

Case report: A 58-year-old male patient recently completed cetuximab-based chemotherapy for metastatic colorectal adenocarcinoma. He presented with acute renal failure, anasarca edema and nephrotic proteinuria. The amount of protein in the 24-h urine test was over 15.6 grams.

Management & outcome: The patient showed a dramatic improvement in renal function shortly after terminated of cetuximab therapy without immunosuppressive therapy.

Discussion: Therefore, drugs targeting epidermal growth factor receptor (EGFR) monoclonal antibody were thought to trigger nephrotic syndrome by causing glomerular damage. As a result, physicians using EGFR monoclonal inhibitors should be very careful about renal functions and proteinuria in patients.

Keywords: Cetuximab; colorectal cancer; nephrotic syndrome.

Publication types

  • Case Reports

MeSH terms

  • Antibodies, Monoclonal / therapeutic use
  • Antineoplastic Agents* / adverse effects
  • Cetuximab / adverse effects
  • Colonic Neoplasms* / drug therapy
  • Colorectal Neoplasms* / drug therapy
  • ErbB Receptors
  • Female
  • Humans
  • Male
  • Middle Aged
  • Nephrotic Syndrome* / chemically induced
  • Protein Kinase Inhibitors / therapeutic use
  • Proteinuria
  • Rectal Neoplasms* / drug therapy

Substances

  • Antibodies, Monoclonal
  • Antineoplastic Agents
  • Protein Kinase Inhibitors
  • ErbB Receptors
  • Cetuximab