Chapter 2:indications and dosing of anticancer drug therapy in patients with impaired kidney function, from clinical practice guidelines for the management of kidney injury during anticancer drug therapy 2022.
Autor: | Nishiyama H; Department of Urology, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan. nishiuro@md.tsukuba.ac.jp., Inoue T; Department of Renal and Urological Surgery, International University of Health and Welfare Narita Hospital, Chiba, Japan., Koizumi Y; Department of Pharmacy, Seichokai Fuchu Hospital, Izumi, Japan., Kobayashi Y; Department of Obstetrics and Gynecology, Keio University School of Medicine, Tokyo, Japan., Kitamura H; Department of Urology, Faculty of Medicine, University of Toyama, Toyama, Japan., Yamamoto K; Department of Pharmacy, Kobe University Hospital, Kobe, Japan., Takeda T; Department of Obstetrics and Gynecology, Keio University School of Medicine, Tokyo, Japan., Yamamoto T; Department of Pharmacy, The University of Tokyo Hospital, Tokyo, Japan., Yamamoto R; Department of Urology, Akita University Graduate School of Medicine, Akita, Japan., Matsubara T; Department of Nephrology, Kyoto University Graduate School of Medicine, Kyoto, Japan., Hoshino J; Department of Nephrology, Tokyo Women's Medical University, Tokyo, Japan., Yanagita M; Department of Nephrology, Kyoto University Graduate School of Medicine, Kyoto, Japan.; Institute for the Advanced Study of Human Biology (ASHBi), Kyoto University, Kyoto, Japan. |
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Jazyk: | angličtina |
Zdroj: | International journal of clinical oncology [Int J Clin Oncol] 2023 Oct; Vol. 28 (10), pp. 1298-1314. Date of Electronic Publication: 2023 Aug 12. |
DOI: | 10.1007/s10147-023-02377-z |
Abstrakt: | This comprehensive review discusses the dosing strategies of cancer treatment drugs for patients with impaired kidney function, specifically those with chronic kidney disease (CKD), undergoing hemodialysis, and kidney transplant recipients. CKD patients often necessitate dose adjustments of chemotherapeutic agents, e.g., platinum preparations, pyrimidine fluoride antimetabolites, antifolate agents, molecularly targeted agents, and bone-modifying agents, to prevent drug accumulation and toxicity due to diminished renal clearance of the administered drugs and their metabolites. In hemodialysis patients, factors such as drug removal from hemodialysis and altered pharmacokinetics demand careful optimization of anticancer drug therapy, including dose adjustment and timing of administration. While free cisplatin is removed by hemodialysis, most of the tissue- and protein-bound cisplatin remains in the body and rebound cisplatin elevations are observed after hemodialysis. It is not recommended hemodialysis for drug removal, regardless of timing. Kidney transplant patients encounter unique challenges in cancer treatment, as maintaining the balance between reduction of immunosuppression, switching to mTOR inhibitors, and considering potential drug interactions with chemotherapeutic agents and immunosuppressants are crucial for preventing graft rejection and achieving optimal oncologic outcomes. The review underscores the importance of personalized, patient-centric approaches to anticancer drug therapy in patients with impaired kidney function. (© 2023. The Author(s) under exclusive licence to Japan Society of Clinical Oncology.) |
Databáze: | MEDLINE |
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