Rare TMA, esp. with mitomycin; mostly renally safe.

Benign creatinine rise via tubular secretion block.

Tumor lysis; lower hypertension than ibrutinib.

Creatinine rise; emerging data.

Diarrhea-driven prerenal AKI.

Creatinine rise via reduced tubular secretion.

Severe hyperglycemia (on-target) → osmotic diuresis and prerenal AKI risk.

Differentiation syndrome; QT prolongation.

Rare AKI; pancreatitis-mediated.

Edema, intracranial bleeding and cognitive effects.

Myeloma ADC; renal data emerging.

Anemia/hypoxia; emerging renal profile in VHL/RCC.

Tumor lysis-mediated AKI is the principal risk; TMA is rare.

Creatinine rise; rhabdomyolysis reports.

Renally excreted (~2/3 in urine); half-life rises exponentially below CrCl 25-35 — exposure/clearance issue amplifying pulmonary toxicity, not a direct nephrotoxin.

CRS and tumor lysis → AKI.

Reversible eGFR decline.

Tumor lysis in lymphoma.

Creatinine elevation; usually benign.

Rare AKI; mostly GI-mediated.

Diarrhea-driven prerenal AKI; dose-adjust for CrCl.

2023 breast-cancer AKT inhibitor; AKI with diarrhea/hyperglycemia.

Reversible creatinine rise and edema.

CRS-driven prerenal AKI and tumor lysis.

Lipophilic oral 5-FU prodrug (Japan); class-level renal risk; hallmark toxicity is leukoencephalopathy not nephropathy.

Trial-stage RCC HIF-2α inhibitor; renal profile being defined.

Intraperitoneal; cytokine-release- and ascites/paracentesis-driven prerenal AKI; withdrawn (EU) 2017.

GI-driven prerenal AKI.

CRS-driven AKI; delayed neurotoxicity.

Proximal tubular ATN + magnesium wasting; the archetype.

Tumor lysis; high-dose nephrotoxicity.

Capillary-leak / SIRS-like AKI and tumor lysis.

Reversible creatinine rise and renal cysts.

Tumor lysis in leukemia; high-dose toxicity.

Rare hepatic veno-occlusive disease; minimal direct renal injury.

Renal risk indirect via tumor lysis in chemosensitive pediatric tumors; hepatic veno-occlusive disease is the signature organ toxicity.

Tumor lysis; usable in renal impairment.

Not nephrotoxic; exposure rises in severe renal impairment, so consider dose adaptation.

Tumor lysis in MDS/AML.

Capillary-leak syndrome → prerenal AKI.

Capillary-leak syndrome, hypertension and severe pain in neuroblastoma.

Fluid retention; low direct renal toxicity.

5'-DFUR prodrug; class-level TMA risk plus a real renal-clearance component warranting caution in renal impairment.

Colitis and diarrhea → prerenal AKI.

2023 oral SERD; nausea-dominant, minimal intrinsic nephrotoxicity.

CRS and tumor lysis — emerging.

Differentiation syndrome and tumor lysis.

Emerging AKI and electrolyte signals in urothelial cancer.

Creatinine rise via reduced tubular secretion.

CRS and tumor lysis — emerging.

Reduced clearance in renal impairment.

Fluid retention, edema and thromboembolism.

Tumor lysis; renally cleared.

Tumor lysis; accumulates in renal impairment.

Tumor lysis and veno-occlusive disease.

Differentiation syndrome, tumor lysis and PRES in AML.

QT prolongation and muscle spasms; AML.

CRS and tumor lysis — emerging.

Tumor lysis in myeloproliferative disease.

Yttrium-90 radioimmunotherapy; tumor lysis with bulky lymphoma.

Tumor lysis, hypertension and AKI.

Tumor lysis in acute leukemia.

CRS-driven AKI and tumor lysis in myeloma.

Immune-mediated colitis → volume-depletion prerenal AKI; transaminitis.

2024 MDS agent; tumor lysis risk.

Tumor lysis and VOD in ALL.

Capillary-leak prerenal AKI.

Diarrhea-driven prerenal AKI.

Tumor lysis in myeloma.

Differentiation syndrome → AKI; tumor lysis.

Kidney-neutral (CLARINET: diarrhea dominant); increased exposure in renal impairment.

2024 cellular therapy; high-dose IL-2 conditioning → capillary leak AKI.

Capillary-leak-type edema, effusions and AKI.

Edema and metabolic effects.

Tumor lysis, edema and QT in AML/mastocytosis.

2025 NF1 MEK inhibitor; creatinine rise and edema.

Ocular toxicity dominates; renal involvement indirect/case-level (GI volume loss).

Indirect: hypoadrenalism drives hyponatremia/prerenal; cisplatin nephrotoxicity in EDP-M.

Tumor lysis; low direct renal toxicity.

Diarrhea-driven prerenal AKI; QT prolongation.

Tumor lysis and rare AKI; cutaneous T-cell lymphoma.

2023 myelofibrosis JAK inhibitor.

CRS and tumor lysis in lymphoma.

Boxed warning for capillary-leak syndrome and hemolytic-uremic syndrome / TMA.

Tumor lysis in T-ALL.

Severe diarrhea → prerenal AKI; loperamide prophylaxis.

eGFR decline over time.

Hypertension and creatinine rise.

High tumor-lysis risk in CLL.

Kidney-neutral/possibly renoprotective; renally cleared, caution in severe CKD/dialysis.

Benign creatinine rise via OCT2/MATE inhibition.

Differentiation syndrome and tumor lysis in AML.

Low direct nephrotoxicity; vehicle reactions.

Generally renally well tolerated.

Rare AKI; pancreatitis- and thrombosis-mediated.

Boxed hepatotoxicity; secondary renal effects.

2023 BTK inhibitor; tumor lysis risk.

Tumor lysis; emerging renal data.

Tumor lysis; usable in renal impairment.

Vascular toxicity and hypertension.

Hypertension; rare AKI.

2023 AML FLT3 inhibitor; tumor lysis and QT.

Bone-seeking alpha emitter; minimal direct renal toxicity.

2023 ROS1 inhibitor; creatinine rise via secretion block.

2024 leukemia agent; differentiation syndrome and tumor lysis.

Creatinine rise; QT prolongation.

Tumor lysis with bulky disease; treats some GN.

Transporter-mediated creatinine rise.

Tumor lysis in myelofibrosis; renally adjusted.

Diarrhea-driven prerenal AKI; emerging direct signals.

Hyponatremia is common and dose-limiting.

Hypertension and creatinine rise.

Creatinine rise in neurofibromatosis.

Newer agent; renal data emerging.

2025 EGFR exon20 TKI; electrolyte effects emerging.

Tumor lysis and infusion reactions in lymphoma.

Capillary-leak syndrome → AKI.

Renally cleared; creatinine rise.

CRS-related AKI — emerging.

2024 small-cell lung BiTE; CRS-driven AKI risk.

Tumor lysis; generally low direct renal toxicity.

CRS-driven hypotension → prerenal AKI early in dosing; uveal melanoma.

CRS-associated AKI in myeloma — emerging signal.

Oral tegafur+uracil; rare fluoropyrimidine-class TMA/HUS (often with mitomycin C), otherwise kidney-sparing.

Highly protein-bound, low renal clearance (~10-25% urinary); renal relevance is PK/exposure not direct injury; not dialyzable.

Creatinine rise and peripheral edema.

Tumor lysis and bradycardia.

Ocular/bleeding toxicity dominates; renal involvement essentially unreported.

Renally cleared; dose-adjust for CrCl.

2024 pediatric glioma RAF inhibitor; creatinine rise.

Differentiation syndrome → capillary leak and AKI.

Benign creatinine rise via tubular secretion inhibition.

Major tumor lysis syndrome risk on ramp-up.

Used because of renal impairment (cisplatin-unfit urothelial); CrCl-based dose bands; watch SIADH/hyponatremia.

2024 biliary-tract HER2 bispecific; renal data emerging.

Tumor lysis in CLL/lymphoma.

Trial-stage AML menin inhibitor; differentiation syndrome / TLS predicted.

2024 gastric mAb; severe on-target nausea/vomiting → volume-depletion prerenal AKI.

HER2 exon20 TKI (2025); creatinine rise likely a secretion artifact.