Anticancer drug renal toxicity and elimination: dosing guidelines for altered renal function

Kintzel, Polly E

doi:10.1016/0305-7372(95)90010-1

Cited by 325 publications

(180 citation statements)

References 162 publications

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“…The glomerular filtration rate progressively declines by about 1% each year after the age of 40 years (Evers et al, 1995). Thus, dose adaptation of drugs with renal elimination has been proposed in case of creatinine clearance lower than 60 ml min À1 (Kintzel and Dorr, 1995). The mean creatinine clearance was about 57 ml min À1 in the present study.…”

Section: Sirmentioning

confidence: 46%

Oxaliplatin- or irinotecan-based chemotherapy for metastatic colorectal cancer in the elderly

Alliot¹,

Barrios²

2004

Br J Cancer

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Section: Sirmentioning

confidence: 46%

Oxaliplatin- or irinotecan-based chemotherapy for metastatic colorectal cancer in the elderly

Alliot¹,

Barrios²

2004

Br J Cancer

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“…The PKs of anthracyclines and their metabolites in the setting of renal dysfunction may correlate to some degree with CrCL, but there are no PK data to support dose adjustment in the presence of impaired renal function [42].…”

Section: Anthracyclinesmentioning

confidence: 99%

“…Methotrexate doses must be reduced in patients with renal dysfunction, and its use should be avoided in patients with severe renal impairment (CrCL Յ30 ml/minute). Kintzel and Dorr [42], in their summary, provided dosing guidelines for methotrexate in the setting of moderate renal dysfunction: a 35% reduction for a CrCL of 46 -60 ml/minute and a 50% reduction for a CrCL of 31-45 ml/minute.…”

Section: Methotrexatementioning

confidence: 99%

“…Significant proportions of ifosfamide and its metabolites are excreted in the urine [42], and because of the greater risk for central nervous system toxicity, ifosfamide doses should be decreased in the presence of renal dysfunction. A dosing regimen based on CrCL has been proposed by Kintzel and Dorr [42]: a 20% reduction for a CrCL of 46 -60 ml/min, a 25% reduction for a CrCL of 31-45 ml/minute, and a 30% reduction for a CrCL of Յ30 ml/minute.…”

Section: Ifosfamidementioning

confidence: 99%

“…A dosing regimen based on CrCL has been proposed by Kintzel and Dorr [42]: a 20% reduction for a CrCL of 46 -60 ml/min, a 25% reduction for a CrCL of 31-45 ml/minute, and a 30% reduction for a CrCL of Յ30 ml/minute.…”

Section: Ifosfamidementioning

confidence: 99%

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Balducci

Extermann

1997

Cancer

120

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individuals and outlines potential guidelines for the management of these patients. Cancer chemotherapy appears less effective in three neoplasms of older individuDepartment of Medicine, University of South als: acute myelogenous leukemia, large cell lymphoma, and coelomic carcinoma Florida College of Medicine, Tampa, Florida.of the ovary. In the case of acute myelogenous leukemia, a higher prevalence of MDR-1 expression and involvement of the pluripotent hematopoietic stem cells in the neoplastic process contribute to chemotherapy resistance. Chemotherapyrelated myelodepression, cardiotoxicity, and peripheral and central neurotoxicity are more common and more severe in older individuals. This toxicity results from the increased vulnerability of target organs and delayed excretion of renally excretable agents. The complications of chemotherapy may be ameliorated by modifying the doses of drugs according to the patient's creatinine clearance, by using antidotes to drug toxicity, and by the early diagnosis and timely management of therapeutic complications. A comprehensive assessment of the older person with cancer allows clinicians to predict the benefits and risks of cancer chemotherapy in individual circumstances.

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Anticancer drug renal toxicity and elimination: dosing guidelines for altered renal function

Cited by 325 publications

References 162 publications

Oxaliplatin- or irinotecan-based chemotherapy for metastatic colorectal cancer in the elderly

Oxaliplatin- or irinotecan-based chemotherapy for metastatic colorectal cancer in the elderly

Commentary: Oncologic Drugs in Patients with Organ Dysfunction: A Summary

Cancer chemotherapy in the older patient

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