Metastatic castration-resistant prostate cancer and the challenge of a patient with chronic kidney disease in hemodialysis

Abstract

At a time when the population shows increasing longevity, entities such as cancer and chronic kidney disease (CKD) are more frequently connected. In the United States, approximately 6% of the patients on hemodialysis have cancer. The challenge to manage oncologic patients with CKD in a hemodialytic program represents a great shortage of available information on the choice of the best drug, timing, dosage adjustments, dialysis method, and treatment safety. We present the case of a patient with prostate cancer and terminal CKD in hemodialysis, and the treatment sequence after the development of resistance to hormonal blockade therapy, which included docetaxel, enzalutamide, and radium-223.

Hemodiyalize Giren Prostat Kanserli Hastada Enzalutamid ile Uzun Süreli Yanıt

“…Therefore, the treatment was reported as safe in patients undergoing HD. Simoes et al preferred 160mg/day treatment and no side effects were reported (9). The treatment is ended 7 months later because of widespread progression.…”

Plasma Levels of Enzalutamide and Its Main Metabolites in a Patient With Metastatic Castration-resistant Prostate Cancer Undergoing Hemodialysis

“…In similar case reports, no significant toxicities were observed. 10,11 Plasma levels were measured at 2 weeks, 1 month, and 2 months after the start of treatment. Although the first sample was taken while plasma concentrations were not yet at steady-state, the enzalutamide concentration was above the suggested target of 5.0 mg/mL.…”

“…Enzalutamide Plasma Concentrations During Hemodialysis treatment without pharmacokinetic assessment. 10,11 We present a case of enzalutamide treatment in a patient with end-stage renal disease undergoing hemodialysis, including plasma levels of enzalutamide, the active metabolite N-desmethyl enzalutamide, and the inactive metabolite enzalutamide carboxylic acid.…”