Abstract 3527: Paraneoplastic glomerulonephropathies associated with solid tumor: A review of published literature

Abstract Background: Paraneoplastic glomerulonephropathies (PGN) are paraneoplastic syndromes associated with solid tumors and hematologic malignancies. PGN is difficult to differentiate from other forms of glomerulonephropathies and standard management of glomerulonephropathies is often ineffective. A delay in diagnosis may lead to significant morbidity and mortality. To date, no retrospective or prospective data on PGN have been published. We reviewed clinical variables, treatment, and outcome in published case reports of PGN associated with solid tumors over the past three decades. Methods: We conducted a search to identify published case reports on solid tumors associated with PGN in English PubMed-indexed journals. Keywords used included: “solid tumor”, “lung cancer”, “gastrointestinal cancer”, “gynecological cancer”, “genitourinary cancer”, “paraneoplastic nephropathy,” “paraneoplastic glomerulopathy,” “minimal change disease,” “IgA nephropathy,” “membranoproliferative,” “membranous,” “nephropathy” and “glomerulonephropathy”. Published articles from January 1st, 1987 to November 30,2019 were screened. Included were the patients who had laboratory and/or biopsy proven nephrotic syndrome in association with a solid tumor diagnosis. Results: We identified 95 patients who fulfilled the inclusion criteria. The median age of the patients were 58 years. The majority of the patients were male (65%). Among them, 37 (39%) were diagnosed with PGN prior to the diagnosis of cancer. Membranous nephropathy (41%) was the most common subtype, followed by minimal change disease (17%), focal segmental glomerulonephritis (14%) and IgA nephropathy (11%). Genitourinary cancers (36%) followed by lung cancers (30%), gastrointestinal cancers (15%) and gynecological cancers (13%) are the common cancers associated with PGN. Among the patients, 44 (46%) had non-metastatic tumors, 39 (41%) had metastatic tumors and 12 (13%) were unspecified. Treatment information were available for 79 of 95 (83%) patients. Overall, PGN improved in 76% of patients who received definitive or systemic therapy with or without steroid compared to 57% of patients who were treated with steroid alone. Definitive and systemic treatment alone led to improvement of PGN in 24 of 29 (83%) patients without metastasis and 13 of 17 (76%) patients with metastasis. Conclusions: PGNs associated with solid tumors are rare and can happen in both non-metastatic and metastatic cancers. Diagnosis of PGN might precede the diagnosis of cancer. Definitive or systemic anticancer therapies improved PGN in most cases and were more effective than steroid alone. Citation Format: Xiaojie Zhang, Asit K. Paul. Paraneoplastic glomerulonephropathies associated with solid tumor: A review of published literature [abstract]. In: Proceedings of the Annual Meeting of the American Association for Cancer Research 2020; 2020 Apr 27-28 and Jun 22-24. Philadelphia (PA): AACR; Cancer Res 2020;80(16 Suppl):Abstract nr 3527.