Renal impairment during pemetrexed maintenance in patients with advanced nonsmall cell lung cancer: a cohort study
| Autor: | Nico van Walree, Jeannine Huisbrink, Anton J.M. van Boxem, Sabine Visser, Bruno H. Stricker, Nils E. van ‘t Veer, Jermo J. van Toor, Joachim G.J.V. Aerts |
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| Přispěvatelé: | Pulmonary Medicine, Epidemiology |
| Rok vydání: | 2018 |
| Předmět: |
Pulmonary and Respiratory Medicine
Oncology Male medicine.medical_specialty Lung Neoplasms Renal function Pemetrexed 03 medical and health sciences 0302 clinical medicine SDG 3 - Good Health and Well-being Internal medicine Carcinoma Non-Small-Cell Lung Antineoplastic Combined Chemotherapy Protocols medicine Carcinoma Humans 030212 general & internal medicine Prospective Studies Renal Insufficiency Prospective cohort study Aged business.industry Middle Aged medicine.disease Discontinuation Logistic Models Treatment Outcome 030220 oncology & carcinogenesis Cohort Female business Kidney disease medicine.drug Cohort study Glomerular Filtration Rate |
| Zdroj: | European Respiratory Journal, 52(4):1800884. European Respiratory Society |
| ISSN: | 0903-1936 |
| Popis: | Optimal survival benefit from different lines of anticancer treatment in advanced nonsmall cell lung cancer (NSCLC) requires conservation of renal function. We evaluated the development of renal impairment during pemetrexed maintenance.In a prospective multicentre cohort study, we evaluated the incidence of acute/chronic kidney disease (AKD/CKD), its related treatment discontinuation frequency and associated clinical variables with AKD in patients with stage IIIB/IV NSCLC treated with pemetrexed maintenance. We validated the findings in an independent cohort.190 patients received pemetrexed. In the primary cohort, 149 patients started induction, of whom 44 patients (30%) continued maintenance. In the independent cohort, 41 patients received maintenance. During maintenance 13 patients (30%) developed AKD, leading to CKD and treatment discontinuation in eight patients (62%) in the primary cohort. Higher estimated glomerular filtration rate (eGFR) (per unit 5 mL·min−1 per 1.73 m2) before maintenance and induction (OR 0.70, 95% CI 0.54–0.90 and OR 0.78, 95% CI 0.62–0.98, respectively) and relative decline (per 10%) in eGFR during induction (OR 2.54, 95% CI 1.36–4.74) were associated with AKD during maintenance. In the independent cohort, 20 patients (49%) developed AKD, leading to CKD in 11 patients (55%) and treatment discontinuation in six patients (30%).Patients are at risk for renal impairment during pemetrexed maintenance, which may jeopardise further lines of anticancer treatment. |
| Databáze: | OpenAIRE |
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