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Preparing your E-Poster
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E-Poster Submission Deadline
Please prepare and upload your E-Poster no later than March 14, 2026 11.59PM CET. After this date, you will no longer be able to prepare and upload your E-poster and it will not be displayed and accessible on the congress website.
Please follow the instructions below to input your abstract title.
Abstract titles should be brief and reflect the content of the abstract.
In patients with malignant neoplasms, the development of significant proteinuria can lead to interruption of treatment. More recently, urinary loss of therapeutic antibodies with consequent reductions in circulating drug concentrations has been recognized, potentially necessitating modifications to treatment plans.
This study aims to identify antineoplastic agents associated with worsening of proteinuria and investigate whether baseline proteinuria is associated with a higher incidence of worsening proteinuria.
In this single-center, retrospective cohort study, we enrolled patients treated with antineoplastic agents from 2018 to 2023 at Kindai University Hospital. Outcome was worsening proteinuria, defined by an increase in dipstick proteinuria by 2 grades or doubling of urine protein-to-creatine ratio (UPCR). Antineoplastic agents associated with worsening proteinuria were identified using the least absolute shrinkage selection operator regression.
The associations were examined by a multilevel mixed-effects logistic regression model in which individual patients and types of malignancy were treated as random effects.
The baseline proteinuria was defined as dipstick proteinuria 1+ or more or UPCR more than 1 g/gCre, and their associations with subsequent worsening proteinuria were evaluated using Kaplan–Meier curves and Cox proportional hazards models.
Of 11,458 patients treated with antineoplastic agents, 7,962 had urine dipstick data available.
Mean age was 66.6 (12.1) years, 56.2% were male, and the mean eGFR was 70.8 (20.8) mL/min/1.73 m²; 21.3% had baseline dipstick proteinuria of 1+ or more.
Vascular endothelial growth factor-tyrosine kinase inhibitors (VEGF-TKIs), anti-VEGF antibodies, and immune checkpoint inhibitors (ICIs) were associated with worsening proteinuria with adjusted odds ratios of 3.39 [95% CI, 2.84–4.05], 2.65 [2.33-3.01], and 1.39 [1.21-1.60], respectively.
Baseline proteinuria was not associated with worsening proteinuria defined by dipstick proteinuria among the users of these agents (HR, 0.40 [95% CI, 0.24-0.66]) with VEGF-TKIs, 0.20 [0.13–0.31] with anti-VEGF-antibodies, and 0.15 [0.08-0.28] with ICIs].
Results were similar when baseline proteinuria was defined as UPCR>1 g/gCre and the endpoint as a doubling of UPCR.
In addition to VEGF-pathway inhibitors, which has been reported to cause proteinuria, we identified that ICIs were associated with worsening proteinuria.
Baseline proteinuria was not associated with worsening proteinuria.
Accordingly, these agents may still be considered for patients with baseline proteinuria, provided that careful monitoring is implemented.
