Impact of renal function on treatment options and outcomes in advanced non-small cell lung cancer

Cenik, Bercin Kutluk; Sun, Han; Gerber, David E.

doi:10.1016/j.lungcan.2013.02.011

Cited by 27 publications

(13 citation statements)

References 41 publications

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“…Cockcroft–Gault formula [15] was selected for the determination renal function status because it is the most commonly used formula in the clinical care of cancer patients. The correlation to measured CrCl in multiple disease settings had been proven [16] . Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) [17] developed a new formulation to estimates renal function.…”

Section: Methodsmentioning

confidence: 99%

Clinical outcome in lung cancer with a second malignancy

Chen²,

Huang³

et al. 2016

Medicine

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The aim of the study was to determine the clinical outcome of lung cancer patients with a secondary malignancy according to the time sequence between the lung cancer and the secondary malignancy.Retrospective review of all lung cancer patients with any secondary cancer treated from June 2004 to July 2012. The survival of patients with a secondary malignancy was compared to those patients without a secondary malignancy. According to the time sequence between the lung cancer and the secondary malignancy, patients were divided into 4 groups. Group I: lung cancer without any other malignancy, Group II: lung cancer with a secondary malignancy at follow-up, Group III: lung cancer with a pre-existing malignancy, Group IV: synchronous malignancies (diagnosis interval between lung cancer and a secondary malignancy of less than 3 months).Patients with any secondary cancer in their history or at follow up included 157 patients (9.5%). Collectively; the median survival was significantly better for patients with a secondary malignancy, 19.09 months, compared to those without a secondary malignancy, 9.53 months, P < 0.001, HR 0.66 (95% CI 0.55 – 0.79). However, the survival differed significantly according to the time sequence between the lung cancer and the secondary malignancy. The median survival was 47.9 months for group II patients, 12.19 months for group III, 17.51 months for group IV, and 9.53 months for group I; P = 0.001. In Cox proportional hazard analysis, the risk of dying decreased by 68% in group II patients compared to group I patients, HR 0.32 (95% CI 0.21–0.5), P < 0.001. Although the risk of dying for group III and IV decreased by 19% and 16% respectively compared to group I patients, it did not reach statistical significance.Nowadays, secondary malignancy in lung cancer patients is a frequent finding. Better survival was observed for patient with secondary malignancy following lung cancer.

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Section: Methodsmentioning

confidence: 99%

Clinical outcome in lung cancer with a second malignancy

Chen²,

Huang³

et al. 2016

Medicine

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“…Over 80% of protocols in our analysis mandated adequate kidney function, commonly defined as a creatinine clearance ≥ 60 mL/min—a threshold that over 20% of lung cancer patients fall below at some point during their treatment history. 31 Accordingly, such restrictions might be limited to trials of therapies cleared renally or conveying renal toxicity. These observations echo those from other fields, including a recent analysis of hematologic malignancy protocols which found that most eligibility criteria did not correlate with known, observed adverse events of study therapy.…”

Section: Discussionmentioning

confidence: 99%

Thoracic Oncology Clinical Trial Eligibility Criteria and Requirements Continue to Increase in Number and Complexity

Garcia

Bisen

Yan

et al. 2017

Journal of Thoracic Oncology

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Background Eligibility criteria and screening procedures are designed to optimize the scientific yield and maximize the safety of clinical trials. However, they may also heighten trial complexity, hinder enrollment, decrease generalizability, and increase costs. We analyzed the types and number of eligibility criteria and screening procedures among thoracic oncology clinical trials sponsored or endorsed by the Eastern Cooperative Oncology Group (ECOG). Methods We identified trials and obtained protocols from the ECOG website. Eligibility criteria were grouped and categorized as comorbidity (classified by organ system), administrative requirements, prior treatment, and measurable disease requirement. Associations between trial characteristics and eligibility criteria were analyzed using Kruskal-Wallis and Wilcoxon tests. Results A total of 74 lung cancer trials activated 1986–2016 were identified. The total number of eligibility criteria was associated with trial principal therapy (median 9 for surgical, 18 for radiation, 20 for medical; P=0.02), trial primary endpoint (median 20 for OS, 28 for PFS, 17 for other; P=0.001), number of therapies (P=0.05), and year of activation (median 16 for 1986–1995, 19 for 1996–2005, 27 for 2006–2016; P<0.001). The increase in trial eligibility requirements over time was limited to medical therapy trials. Over time, there was also an increase in blood test screening procedures (P=0.05), but not for imaging, cardiac assessment, or pulmonary function screening procedures. Conclusions The number of eligibility criteria and screening procedures in medical therapy lung cancer clinical trials continues to rise. Continued efforts to simplify protocol eligibility and procedures are warranted to promote trial adherence, enrollment, completion, and generalizability.

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“…CKD staging was conducted in accordance with the current international guidelines . The Cockcroft–Gault formula, the most commonly used formula to determine renal function status in the clinical care of cancer patients, has been shown to correlate with measured CrCl in multiple disease settings . A recent formulation to estimate renal function was developed by the Chronic Kidney Disease Epidemiology Collaboration (CKD‐EPI) .…”

Section: Methodsmentioning

confidence: 99%

Is chronic kidney disease an adverse factor in lung cancer clinical outcome? A propensity score matching study

Chen

Lin

et al. 2017

Thoracic Cancer

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BackgroundComorbidity has a great impact on lung cancer survival. Renal function status may affect treatment decisions and drug toxicity. The survival outcome in lung cancer patients with coexisting chronic kidney disease (CKD) has not been fully evaluated. We hypothesized that CKD is an independent risk factor for mortality in patients with lung cancer.MethodsA retrospective, propensity‐matched study of 434 patients diagnosed between June 2004 and May 2012 was conducted. CKD was defined as estimated glomerular filtration rate <60 mL/minute. Lung cancer and coexisting CKD patients were matched 1:1 to patients with lung cancer without CKD.ResultsAge, gender, smoking status, histology, and lung cancer stage were not statistically significantly different between the CKD and non‐CKD groups. Kaplan–Meier survival analysis demonstrated a median survival of 7.26 months (95% confidence interval [CI] 6.06–8.46) in the CKD group compared with 7.82 months (95% CI 6.33–9.30) in the non‐CKD group (P = 0.41). Lung cancer stage‐specific survival is not affected by CKD. Although lung cancer patients with CKD presented with an increased risk of death of 6%, this result was not statistically significant (hazard ratio 1.06, 95% CI 0.93–1.22; P = 0.41).ConclusionAccording to our limited experience, CKD is not an independent risk factor for survival in lung cancer patients. Clinicians should not be discouraged to treat lung cancer patients with CKD.

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Impact of renal function on treatment options and outcomes in advanced non-small cell lung cancer

Cited by 27 publications

References 41 publications

Clinical outcome in lung cancer with a second malignancy

Clinical outcome in lung cancer with a second malignancy

Thoracic Oncology Clinical Trial Eligibility Criteria and Requirements Continue to Increase in Number and Complexity

Is chronic kidney disease an adverse factor in lung cancer clinical outcome? A propensity score matching study

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