Toxicity, risk factors and management of cisplatin-induced toxicity: A prospective study

Abstract

Background and propose Cisplatin is a cytotoxic drug that triggers several toxicities. However, nephrotoxicity and ototoxicity remain major clinical limitations. The aim of our study was to evaluate the incidence of chemotherapy toxicity induced by cisplatin and to analyze the influence of risk factors in the Tunisian population. Methods We performed a prospective descriptive study in a period of four months. Patients were eligible if they had pathologically confirmed malignancies and treated with cisplatin-regimen chemotherapy. Nephrotoxicity and digestive toxicity were graded according to the World Health Organization toxicity scale and ototoxicity was scored clinically according to the Common Terminology Criteria for Adverse Events (CTCAE). Multivariate logistic regression analysis was performed to evaluate the influence of clinical variables on cisplatin-induced toxicity. Results A total of 150 patients were included. Forty-four percent of patients developed cisplatin-regimen toxicity: 15% developed cisplatin-induced nephrotoxicity, 9% cisplatin-induced ototoxicity and 27% digestive toxicity. In the multivariate analysis, age >65 years (OR= 6.129, p = 0.010), metastatic cancer (OR = 0.171, p = 0.007) and cumulative dose (OR= 1.004 mg/m2; p = 0.042) were strong predisposing factors for CDDP-induced nephrotoxicity. The cumulative dose was an independent prognostic indicator for digestive toxicity (OR = 0.997, p = 0.002). Conclusion In our study, age >65 years and metastatic cancer were risk factors for cisplatin-induced nephrotoxicities. We also found the correlation between cumulative dose and nephrotoxicity or digestive toxicity.

Nanocurcumin preserves kidney function and haematology parameters in DMBA-induced ovarian cancer treated with cisplatin via its antioxidative and anti-inflammatory effect in rats

“…In this study, the cisplatin dose selected was enough to produce antitumour efficacy yet still raised concerns regarding bone marrow suppression (Perše and Večerić-Haler 2018 ; Higuchi and Yanagawa 2019 ; Ben Ayed et al. 2020 ; Arita et al. 2021 ).…”

“… 2019 ; Ben Ayed et al. 2020 ). Some of the known mechanisms of organ toxicities of cisplatin are the activation of inflammatory and oxidative stress pathways (Mikuła-Pietrasik et al.…”

Selenium Status in Diet Affects Nephrotoxicity Induced by Cisplatin in Mice

“…Nephrotoxicity is the most serious adverse effect of cisplatin [ 12 , 13 , 44 , 45 , 46 ], and currently, effective approaches to relieve it are limited. The supplementation with selenium is an interesting topic for alleviating DDP-induced toxicity, but thus far it is still inconclusive [ 37 , 38 , 39 ].…”

“…There are approximately 40 specific toxicities of cisplatin, including nephrotoxicity, ototoxicity, hepatotoxicity, cardiotoxicity, gastrointestinal toxicity, neurotoxicity, and hematological toxicity. Among these side effects, nephrotoxicity is the most common one [ 6 , 12 , 13 , 14 , 15 ]. It has been reported that oxidative damage caused by excessive reactive oxygen species (ROS) is one of the main causes of cisplatin nephrotoxicity [ 16 , 17 , 18 ].…”

Comparison of Equations To Estimate Glomerular Filtration Rate and Their Impact on Frequency of Cisplatin-associated Acute Kidney Injury

“…However, the relative proportions of C-AKI across various equations were not profoundly different for two possible reasons: First, baseline kidney function by eGFR or eCrCl alone has not been consistently shown to predict C-AKI. [36][37][38][39][40][41] Second, our cohort, despite being very large and inclusive, did not have many patients with very low eGFR (ie, patients who would presumably be at highest risk of C-AKI). The mean eGFRCKD-EPI in the <60 ml/min/1.73 m 2 group was 51.3 ml/min/1.73 m 2 .…”