Influence of Combination Chemotherapy with &lt;i&gt;cis&lt;/i&gt;-Diamminedichloroplatinum on Renal Function: Long-Term Effects

Meijer, S; Mulder, Nh; Sleijfer, Dt; Donker, A. J. M.; Sluiter, Wj; Dejong, Pe; Koops, H. Schraffordt; Vanderhem, Gk

doi:10.1159/000225718

Cited by 18 publications

(3 citation statements)

References 9 publications

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“…In spite of adequate hydration, the patients treated with cisplatin had a decrease in GFR of more than 25% from the baseline values in 29% of patients, which is similar to the value reported in the literature [10], Usually, the renal impairment is still observed at least 6 months after the end of chemotherapy and correlates with age, cumulative dose of cisplatin and the presence of dehydration [12], Hypomagnesemia is common with cisplatin doses of more than 40 mg/m2 [7] and may necessitate oral and intravenous magnesium supplements [14], In the present study, magnesium supplements were given but significant hypomagnesemia was still found in 4 patients (14%). Dur ing chemotherapy serum magnesium values decreased significantly from 1.67 ± 0.08 to 1.32 ± 0.06 mg/dl (p<…”

Section: Discussionsupporting

confidence: 87%

Increased Nephrotoxicity of Combination Taxol and Cisplatin Chemotherapy in Gynecologic Cancers as Compared to Cisplatin Alone

Mérouani

Davidson

Schrier³

1997

Am J Nephrol

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To investigate the increased nephrotoxicity of taxol and cisplatin combination chemotherapy in gynecologic cancers as compared to cisplatin alone, the medical records of 25 patients with gynecological cancers were reviewed for evaluation of nephrotoxicity after chemotherapy treatment. The data included age, serum creatinine, calculated creatinine clearance, initial and cumulative dose of cisplatin and taxol, primary site of the cancer, renal ultrasound and hydration protocols. Renal function was evaluated before, during and 6 months after chemotherapy. Renal dysfunction was defined as a greater than 25% decrease in creatinine clearance. Comparing 11 patients treated with taxol and cisplatin versus 14 treated with cisplatin alone, there was a significant difference in effect on renal function. Nine of 11 patients (81%) treated with the combination chemotherapy had a greater than 25% decrease in creatinine clearance while only 4 of the 14 patients (29%) treated with cisplatin alone had such a decrease in creatinine clearance (p < 0.004). The patients treated with the combination chemotherapy, however, received a higher dose of cisplatin (80.4 vs. 66.4 mg/m², p < 0.02) and were treated longer (6.7 vs. 4.3 months, p < 0.002). Nevertheless, when the patients were matched for age, initial dose and cumulative dose of cisplatin, a higher frequency of nephrotoxicity persisted in patients treated with taxol and cisplatin as compared to cisplatin alone (72 as compared to 20%, p < 0.02). The patients in both groups were comparably hydrated; prerenal failure and urinary tract obstruction were excluded in all patients. Six months after completion of chemotherapy, a significantly lower creatinine clearance was still observed in patients treated with taxol and cisplatin combination therapy (46 vs. 76 ml/min, p < 0.01). In summary, a retrospective analysis of renal function in patients with gynecological cancers showed an increased nephrotoxicity in patients treated with taxol and cisplatin as compared to cisplatin alone. A prospective study is therefore needed to examine the potential additive toxic effect of the combination of taxol and cisplatin on long-term renal function, including potential preventive interventions.

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Section: Discussionsupporting

confidence: 87%

Increased Nephrotoxicity of Combination Taxol and Cisplatin Chemotherapy in Gynecologic Cancers as Compared to Cisplatin Alone

Mérouani

Davidson

Schrier³

1997

Am J Nephrol

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“…Our study, which included a greater diversity of tumor types, supports this initial decline in eGFR. In previous studies in which GFR and renal plasma flow were measured using exogenous filtration markers and 24-hour creatinine clearance, the observed acute and chronic declines in GFR were of larger magnitude, ranging from 12% to 23% (12,13,15,(20)(21)(22). In our study, a lower median decline in eGFR of 10 ml/min per m 2 was observed.…”

Section: Discussionmentioning

confidence: 93%

Long–Term Renal Outcomes after Cisplatin Treatment

Latcha

Jaimes

Patil

et al. 2016

CJASN

174

125

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Background and objectives Nephrotoxicity remains the dose-limiting side effect of cisplatin, an effective chemotherapeutic agent with applications across diverse tumor types. This study presents data on renal outcomes across multiple tumor types in 821 adults. We report on incidence of AKI, initial and long-term changes in eGFR after cisplatin, and relationships between cumulative dose, initial eGFR, age, sex, and long-term renal function.Design, setting, participants, & measurements This was a retrospective study of adult patients treated with cisplatin from January 1, 2000 to September 21, 2011 who had survived $5 years after initial dose. The Modification of Diet in Renal Disease equation was used to calculate eGFR. AKI was defined as an increase from the baseline creatinine of .25% within 30 days after the first cycle of cisplatin. Chi-squared tests were done to evaluate the relationships between categorical or ordinal variables; ANOVAs or t tests were used to evaluate continuous or categorical variables. Changes in eGFR over time were evaluated in a growth curve model.Results Mean follow-up was 6 years (25th and 75th percentiles, 4 and 9 years). AKI occurred in 31.5% of patients, with a median initial decline in eGFR of 10 ml/min per 1.73 m 2 (25th and 75th percentiles, 241.5 and 223.3 ml/min per 1.73 m 2 ). At any time point after the first cycle of cisplatin, ,3% of patients progressed to eGFR,29 ml/min per 1.73 m 2 , and none were known to be on dialysis. Age was associated with a higher risk for AKI after cisplatin. Compared with age ,25 years old, the odds ratios for AKI versus no AKI are 1.22 for .26-44 years old (95% confidence interval [95% CI], 0.60 to 2.4), 1.54 for .45-65 years old (95% CI, 0.78 to 3), and 2.96 for .66 years old (95% CI, 1.4 to 6.1). The lowest dose categories of cisplatin (#100 and 101-250 mg/m 2 ) are associated with increases in eGFR (P=0.06 and P=0.02, respectively) compared with the highest dose category (.701 mg/m 2 ).Conclusions This is the largest study of adult patients with cancer who received cisplatin for treatment across multiple tumor types. Most patients experience small but permanent declines in eGFR, but none progressed to ESRD requiring hemodialysis.

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“…Its application is accompanied by doselimiting side-effects, such as nephro-, neuro-and ototoxicity (Kovacs et al, 1982;Meijer et al, 1983;Vermorken et al, 1983). Despite its long-standing and wide clinical application, the optimal schedule of CDDP, with a maximal attainable anti-tumour effect and tolerable side-effects, has never been clearly established.…”

mentioning

confidence: 99%

Pharmacokinetic-dynamic relationship of cisplatin in vitro: simulation of an i.v. bolus and 3 h and 20 h infusion

Verweij²,

Kolker³

et al. 1994

Br J Cancer

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SummaryThe profiles of an i.v. bolus and 3 h and 20 h infusion of cisplatin (CDDP) were simulated in vitro by using a culture of the IGROVI human ovarian cancer cell line. Disappearance of pharmacologically active unbound CDDP was accomplished by adding human albumin to the medium. Total and unbound CDDP and CDDP-DNA adduct levels were quantitated by atomic absorption spectroscopy (AAS), and tumour cell survival was measured by the clonogenic assay. The design of the experiment resulted in non-significant differences in the magnitude of the area under the concentration-time curve (AUC) of unbound CDDP between the three dose-input functions (AUC i.v. bolus, 6.34 ± 0.36; 3 h infusion, 6.35 ± 0.59; and 20 h infusion, 6.76 ± 0.40 pg h ml-'). Also, the differences between the area under the CDDP-DNA adduct -time curves (AUA) of the three dose-input functions were not significant. The initial rate of decline of the CDDP-DNA adduct-time curve was significantly higher for the i.v. bolus and 3 h infusion than for the 20 h infusion. There was a log-linear relationship between the AUC of unbound CDDP and cell survival. These relationships were not significantly different between the three dose-input functions. Variation in the rate of input of CDDP leads to differences in the shape of the AUC and AUA without significant effects on cell survival.

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Influence of Combination Chemotherapy with <i>cis</i>-Diamminedichloroplatinum on Renal Function: Long-Term Effects

Cited by 18 publications

References 9 publications

Increased Nephrotoxicity of Combination Taxol and Cisplatin Chemotherapy in Gynecologic Cancers as Compared to Cisplatin Alone

Increased Nephrotoxicity of Combination Taxol and Cisplatin Chemotherapy in Gynecologic Cancers as Compared to Cisplatin Alone

Long–Term Renal Outcomes after Cisplatin Treatment

Pharmacokinetic-dynamic relationship of cisplatin in vitro: simulation of an i.v. bolus and 3 h and 20 h infusion

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