ArticleFrontiers in oncology2026
Case Report: Glomerular microangiopathy and reversible renal toxicity during prolonged bevacizumab therapy in ovarian cancer.
Article in Frontiers in oncology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Bevacizumab, a VEGF-A inhibitor widely used in ovarian cancer, is associated with kidney adverse effects ranging from mild proteinuria to thrombotic microangiopathy (TMA). However, the longitudinal course, reversibility, and spectrum of kidney-limited injury remain under-characterized. Case report: We describe three patients with ovarian cancer who developed proteinuria during prolonged bevacizumab therapy, including one with biopsy-proven kidney-limited glomerular microangiopathy. Proteinuria emerged after 6 to 12 months of exposure in all cases. Kidney function remained preserved throughout treatment. All three patients discontinued bevacizumab, after which proteinuria consistently improved. Two patients experienced complete resolution within 3 to 6 months, and one showed marked reduction to dipstick 1 plus by three months. Kidney biopsy in one case revealed double-contour basement membrane changes and subendothelial electron-dense deposits, confirming kidney-limited TMA without systemic microangiopathic findings. Conclusion: These cases illustrate the characteristic time course of bevacizumab-induced kidney toxicity, highlight the reversibility of proteinuria following drug discontinuation, and demonstrate that bevacizumab can induce kidney-limited TMA in the absence of systemic microangiopathic features. Multidisciplinary management is essential to balance oncologic benefit with kidney safety.
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