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During the congress, E-Posters will be accessible to all participants on the congress website 24/7, as well as in the E-poster stations in the congress center.
Preparing your E-Poster
Please review the E-Poster format requirements carefully when preparing your E-Poster. Should your E-Poster not meet the mentioned requirements, it may not be displayed as described above.
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.
Bevacizumab, a monoclonal antibody against vascular endothelial growth factor (VEGF), improves outcomes in advanced malignancies but can precipitate kidney toxicity. Real-world data from Southeast Asia are limited. This study evaluated the prevalence, spectrum, predictors, nephrology referral patterns, and survival outcomes of bevacizumab-associated kidney toxicity in a multi-ethnic Malaysian cohort.
We conducted a retrospective real-world cohort study of 329 patients treated with bevacizumab at Universiti Malaya Medical Centre between August 2018 and August 2025. Eligible patients were ≥18 years with baseline kidney function and ≥3 months follow-up. Clinical data, including kidney function parameters were extracted at baseline and at 3, 6, 9, and 12 months post-Bevacizumab initiation. Significant kidney toxicity was defined as: (1) worsening kidney function (≥30% decline in eGFR), (2) worsening proteinuria (progression in KDIGO 2025 CKD albuminuria category), or (3) severe electrolyte disturbance (e.g., hyponatremia, hypernatremia, hypokalemia, hyperkalemia, metabolic acidosis, or metabolic alkalosis).
The cohort (median age 61 years; 64.4% female; 76.0% Chinese) primarily had colorectal cancer (51.7%), with 87.5% with stage IV disease and 95.4% receiving concomitant chemotherapy. Pre-existing chronic kidney disease (CKD) was present in 3.6%. Median follow-up was 14 months (IQR 8-22.5). Overall, 53.5% developed kidney toxicity: 20.6% with ≥30% eGFR decline, 34.3% with worsening proteinuria, and 42.2% with severe electrolyte disturbance, predominantly hyponatremia. Mean eGFR decreased from 83.4 to 76.4 ml/min/1.73m² (p<0.001). The mean time to first ≥30% eGFR decline was 11.7 months. Median overall survival (OS) was significantly shorter in patients with kidney toxicity (20.0 months; 95% CI, 15.6–24.4) compared to those without (mean OS 50.8 months; p<0.001). In multivariate Cox regression, kidney toxicity remained independently associated with mortality (adjusted HR 2.55; 95% CI, 1.70–3.83; p<0.001). Multivariate analysis identified pre-existing CKD (adjusted OR 3.97; p=0.025) and diabetes mellitus (adjusted OR 2.11; p=0.043) as significant predictors for worsening kidney function and worsening proteinuria, respectively. 92.6% of toxicity cases had no nephrology referral and none underwent kidney biopsy.
These findings contribute to the growing body of evidence that bevacizumab-associated kidney toxicity is frequent in real-world Southeast Asian oncology practice, yet nephrology referral remains rare. The coexistence of frequent toxicity and relatively prolonged survival highlights the importance of embedding onconephrology into cancer care. This study underscores the urgent need for structured surveillance, timely nephrology involvement, and prospective onconephrology research, aiming to develop predictive models and evidence-based guidelines to mitigate kidney complications and optimise outcomes in oncology populations.
