Monitoring Proteinuria in Bevacizumab Therapy

Alternative Monitoring Tools

• Random urine protein‑to‑creatinine ratio can be used as an alternative to 24‑hour urine collection for assessing proteinuria in patients receiving bevacizumab. 1

Management Algorithm for Bevacizumab‑Associated Proteinuria

• When dipstick proteinuria reaches a 2+ reading or higher, clinicians should obtain either a 24‑hour urine protein measurement or a random urine protein‑to‑creatinine ratio to quantify proteinuria and guide treatment decisions. 1

Guidance from Related VEGF‑Inhibitor Guidelines

• Korean hepatocellular carcinoma guidelines recommend interrupting lenvatinib (another VEGF inhibitor) if 24‑hour urinary protein is ≥ 2 g, a threshold that aligns with bevacizumab proteinuria management. 1
• The same Korean guidelines allow a random urinary protein‑to‑creatinine ratio to substitute for a 24‑hour collection when monitoring proteinuria in patients on VEGF inhibitors such as bevacizumab. 1