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Many of these therapies have been approved for use with remarkable success in breast, blood, colorectal, lung, and ovarian cancers. The advantage over conventional chemotherapy is its ability to deliver drugs effectively with high specificity while being less toxic. Although known as \u201ctargeted,\u201d many of these agents lack specificity and selectivity, and they tend to inhibit multiple targets, including those in the kidneys. The side effects usually arise because of dysregulation of targets of the inhibited molecule in normal tissue. The off-target effects are caused by drug binding to unintended targets. The on-target effects are associated with inhibition toward the pathway reflecting inappropriate inhibition or activation of the intended drug target. Early detection and correct management of kidney toxicities is crucial to preserve kidney functions. The knowledge of these toxicities helps guide optimal and continued utilization of these potent therapies. This review summarizes the different types of molecular targeted therapies used in the treatment of cancer and the incidence, severity, and pattern of nephrotoxicity caused by them, with their plausible mechanism and proposed treatment recommendations.<\/jats:p>","DOI":"10.34067\/kid.0000000566","type":"journal-article","created":{"date-parts":[[2024,8,26]],"date-time":"2024-08-26T12:09:43Z","timestamp":1724674183000},"page":"1750-1762","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":9,"title":["Acute Kidney Injury Associated with Anticancer Therapies: Small Molecules and Targeted Therapies"],"prefix":"10.34067","volume":"5","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2056-1721","authenticated-orcid":false,"given":"Jaya","family":"Kala","sequence":"first","affiliation":[{"name":"Division of Nephrology, Department of Internal Medicine, University of Texas Health Science Center-McGovern Medical School, Houston, Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-2678-1383","authenticated-orcid":false,"given":"Teresa","family":"Joseph","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Department of Internal Medicine, University of Texas Health Science Center-McGovern Medical School, Houston, Texas"},{"name":"Section of Nephrology, Department of Internal Medicine, Yale School of Medicine, New Haven, CT"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9737-7052","authenticated-orcid":false,"given":"Marta","family":"Pirovano","sequence":"additional","affiliation":[{"name":"Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy"},{"name":"Dana-Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8019-5749","authenticated-orcid":false,"given":"Roberta","family":"Fenoglio","sequence":"additional","affiliation":[{"name":"University Center of Excellence on Nephrological, Rheumatological and Rare Diseases (ERK-net, ERN-Reconnect and RITA-ERN Member) including Nephrology and Dialysis Unit and Center of Immuno-Rheumatology and Rare Diseases (CMID), Turin, Italy"},{"name":"Coordinating Center of the Interregional Network for Rare Diseases of Piedmont and Aosta Valley (North-West Italy), San Giovanni Bosco Hub Hospital, ASL Citt\u00e0di Torino, Turin, Italy"},{"name":"Department of Clinical and Biological Sciences of the University of Turin, Turin, 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