Analysis of Risk Factors Associated with Urinary Protein Expression of Cabozantinib in Renal Cell Carcinoma

Proteinuria is one of the side effects to be monitored in patients receiving cabozantinib. Identifying the risk factors for its development is crucial for its early detection. Therefore, in this retrospective study, we reviewed the medical records of patients with renal cell carcinoma who received cabozantinib at Tokai University Hospital between May 2020 and December 2023, with the aim to investigate the risk factors associated with urinary protein expression in patients with renal cell carcinoma receiving cabozantinib. To identify the predictors of proteinuria ≥ grade 2, we compared the baseline characteristics at cabozantinib initiation between the two patient groups: those with proteinuria < grade 2 and those with proteinuria ≥ grade 2. Univariate analysis was performed to assess potential risk factors, and variables with P < 0.1 were further analyzed using multivariate logistic regression to calculate odds ratios (OR) and 95％ confidence intervals (95％ CI). Among the 37 participants, 12 (32.4％) developed grade 2 proteinuria. The univariate analysis showed significant differences in risk factors between diabetes medication use (P = 0.016) and baseline proteinuria grade 1 (P = 0.006) cohorts. The multivariate analysis further confirmed a significant increase in proteinuria ≥ grade 2 development in the diabetes medication use (OR: 17.50, 95％ CI: 1.41 – 218.00, P = 0.026) and baseline proteinuria grade 1 (OR: 10.40, 95％ CI: 1.63 – 67.10, P = 0.013) groups. These findings indicate that patients with risk factors at the start of cabozantinib treatment should be carefully monitored to facilitate early detection.