Novel Algorithm for More Accurate Calculation of Renal Function in Adults with Cancer

Holweger, Karin; Lipp, Hans‐Peter; Dietz, Klaus; Hartmann, J. T.; Bokemeyer, Carsten

doi:10.1345/aph.1l216

Cited by 22 publications

(14 citation statements)

References 26 publications

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“…In spite of this low proportion of patients with elevated SCR and/or diagnosed kidney disease, a majority of patients had in fact a decreased GFR when estimating the GFR with the aMDRD formula: 64.0% had a decreased GFR<90 ml min −1 per 1.73 m 2 (Table 2). Such an estimation of renal function has become the reference method in cancer patients (Kleber et al , 2007; Barraclough et al , 2008; Holweger et al , 2008). Furthermore, when focusing on the patients with a normal SCR (1023 patients), a high prevalence of decreased GFR (665 patients, 65.0%) was also found, meaning that the risk of missing a diagnostic of RI is important if an estimation of the GFR is not performed.…”

Section: Resultsmentioning

confidence: 99%

Cancer and renal insufficiency results of the BIRMA study

et al. 2010

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Background:Half of anticancer drugs are predominantly excreted in urine. Dosage adjustment in renal insufficiency (RI) is, therefore, a crucial issue. Moreover, patients with abnormal renal function are at high risk for drug-induced nephrotoxicity. The Belgian Renal Insufficiency and Anticancer Medications (BIRMA) study investigated the prevalence of RI in cancer patients, and the profile/dosing of anticancer drugs prescribed.Methods:Primary end point: to estimate the prevalence of abnormal glomerular filtration rate (GFR; estimated with the abbreviated Modification of Diet in Renal Disease formula) and RI in cancer patient. Secondary end point: to describe the profile of anticancer drugs prescribed (dose reduction/nephrotoxicity). Data were collected for patients presenting at one of the seven Belgian BIRMA centres in March 2006.Results:A total of 1218 patients were included. The prevalence of elevated SCR (⩾1.2 mg per 100 ml) was 14.9%, but 64.0% had a GFR<90 ml min−1 per 1.73 m2. In all, 78.6% of treated patients (n=1087) were receiving at least one drug needing dosage adjustment and 78.1% received at least one nephrotoxic drug. In all, 56.5% of RI patients receiving chemotherapy requiring dose reduction in case of RI did not receive dose adjustment.Conclusions:The RI is highly frequent in cancer patients. In all, 80% of the patients receive potentially nephrotoxic drugs and/or for which dosage must be adjusted in RI. Oncologists should check the appropriate dose of chemotherapeutic drugs in relation to renal function before prescribing.

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Section: Resultsmentioning

confidence: 99%

Cancer and renal insufficiency results of the BIRMA study

et al. 2010

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“…Very recently, we proposed a novel algorithm to be beneficial compared to other available mathematical calculation strategies [9][10][11] because three formulas [11][12][13] rather than one single formula may reflect the real situation of a broad GFR range more closely (figure 1) [14]. In order to prove the validity of this algorithm in clinical practice, we determined carboplatin-AUC values based on a limited sampling method by atomic absorption spectrometry (AAS) and compared the measured carboplatin AUC with predictive values calculated via different GFR ways substituted into the Calvert formula (Table 1).…”

Section: Introductionmentioning

confidence: 99%

“…In order to prove the validity of this algorithm in clinical practice, we determined carboplatin-AUC values based on a limited sampling method by atomic absorption spectrometry (AAS) and compared the measured carboplatin AUC with predictive values calculated via different GFR ways substituted into the Calvert formula (Table 1). We include the broadly accepted Jelliffe-and Cockcroft-Gault formula [9,10], the Hoek formula [15,16] based on cystatin C measurements, as well as endogenous CrCl measurements based on 24-hour-urine collection and the novel algorithm [14].…”

Section: Introductionmentioning

confidence: 99%

Evaluation of a non cystatin-C-based novel algorithm to calculate individual glomerular filtration rate in cancer patients receiving carboplatin

Holweger¹,

Lipp²,

Beijnen

et al. 2010

Cancer Chemother Pharmacol

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“…The determination of GFR based on clearance of 51 Cr‐EDTA is unavailable in most hospitals [14]. Various equations of creatinine clearance have been proposed to calculate the appropriate dose for a target exposure in a patient with a known GFR [12,13,15,16]. However, there is no current consensus about which formula should be used to calculate creatinine clearance in a way that produces the greatest impact possible on survival and quality of life in the elderly [17].…”

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confidence: 99%

Effect of Age on Systemic Exposure and Haematological Toxicity of Carboplatin in Advanced Non-Small Cell Lung Cancer Patients

Merino-Sanjuán

Monteiro

Porta-Oltra

et al. 2011

Basic &Amp; Clinical Pharmacology &Amp; Toxicology

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The aim of this study was to evaluate systemic exposure to carboplatin and its haematological toxicity in patients with advanced non-small cell lung cancer both older and younger than 70 years when the target area under the curve (AUC) in elderly patients was reduced by 20%. For this purpose, a population pharmacokinetic model was developed and the haematological toxicity of the drug was assessed. A total of 33 patients received carboplatin on day 1 and gemcitabine (1250 mg ⁄ m 2 ) on days 1 and 8. This schedule was repeated every 21 days. The Calvert-Crokcoft-Gault formula was employed to calculate a dose of carboplatin with a target AUC of 5 mg ⁄ min. ⁄ mL in patients under 70 years and 4 mg ⁄ min. ⁄ mL in patients aged 70 or older. The data of 24 patients were treated for population modelling performed with the NONMEM (University of California, San Francisco, CA, USA) approach. Haematological toxicity was evaluated for all 33 patients enrolled in the study. The carboplatin systemic exposure measured by the AUC (mg ⁄ min. ⁄ mL) was 5.98 (5.45; 6.51) and 5.36 (5.02; 5.69) for the younger patients and older groups, respectively. No significant differences were observed between the two groups with respect to rates of grade 3+ anaemia, neutropenia or thrombocytopenia. In clinical practice, a target AUC of 4 mg ⁄ min. ⁄ mL carboplatin is applied to patients aged 70 and over, but the actual systemic exposure to the drug is higher. This supports a target AUC of 4 mg ⁄ min. ⁄ mL carboplatin for patients older than 70 years when the dose is calculated by means of the Calvert-Crokcoft-Gault formula.

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Novel Algorithm for More Accurate Calculation of Renal Function in Adults with Cancer

Cited by 22 publications

References 26 publications

Cancer and renal insufficiency results of the BIRMA study

Cancer and renal insufficiency results of the BIRMA study

Evaluation of a non cystatin-C-based novel algorithm to calculate individual glomerular filtration rate in cancer patients receiving carboplatin

Effect of Age on Systemic Exposure and Haematological Toxicity of Carboplatin in Advanced Non-Small Cell Lung Cancer Patients

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