Renal toxicity of anticancer agents targeting HER2 and EGFR

J Nephrol. 2015 Dec;28(6):647-57. doi: 10.1007/s40620-015-0226-9. Epub 2015 Sep 4.


EGFR and HER2 are found overexpressed and/or activated in many different human malignancies (e.g. breast and colon cancer), and a number of drugs specifically targeting these two tyrosine kinases have been developed over the years as anticancer agents. In the present review, the renal safety profile of presently available agents targeting either HER2 or EGFR will be discussed, together with the peculiarities related to their clinical use in patients with impaired renal function, or even in dialysis. Indeed, even though renal toxicity is not so common with these agents, it may nevertheless happen, especially when these agents are combined with traditional chemotherapeutic agents. As a whole, kidney impairment or dialysis should not be regarded per se as reasons not to administer or to stop an active anti-HER or anti-EGFR anticancer treatment, especially given the possibility of significantly improving the life expectancy of many cancer patients with the use of these agents.

Keywords: Dialysis; EGFR inhibitors; HER2-targeting agents; Kidney impairment; Kidney toxicity.

Publication types

  • Review

MeSH terms

  • Acute Kidney Injury / chemically induced*
  • Ado-Trastuzumab Emtansine
  • Afatinib
  • Antibodies, Monoclonal, Humanized / adverse effects
  • Antineoplastic Agents / adverse effects*
  • Antineoplastic Agents / pharmacology
  • Cetuximab / adverse effects
  • ErbB Receptors / antagonists & inhibitors*
  • Erlotinib Hydrochloride / adverse effects
  • Gefitinib
  • Humans
  • Lapatinib
  • Maytansine / adverse effects
  • Maytansine / analogs & derivatives
  • Neoplasms / drug therapy*
  • Protein Kinase Inhibitors / adverse effects*
  • Protein Kinase Inhibitors / pharmacology
  • Quinazolines / adverse effects
  • Receptor, ErbB-2 / antagonists & inhibitors*
  • Renal Dialysis
  • Renal Insufficiency, Chronic / therapy
  • Trastuzumab / adverse effects


  • Antibodies, Monoclonal, Humanized
  • Antineoplastic Agents
  • Protein Kinase Inhibitors
  • Quinazolines
  • Lapatinib
  • Maytansine
  • Afatinib
  • Erlotinib Hydrochloride
  • ERBB2 protein, human
  • ErbB Receptors
  • Receptor, ErbB-2
  • pertuzumab
  • Trastuzumab
  • Cetuximab
  • Gefitinib
  • Ado-Trastuzumab Emtansine