Renal insufficiency is the leading cause of double maintenance (bevacizumab and pemetrexed) discontinuation for toxicity to advanced non-small cell lung cancer in real world setting

Sassier, Marion; Dugué, Audrey Emmanuelle; Clarisse, Bénédicte; Lesueur, Paul; Avrillon, Virginie; Bizieux-Thaminy, Acya; Auliac, J.B.; Kaluzinski, Laure; Tillon, J.; Robinet, G.; Caer, H. Le; Monnet, I.; Madroszyk, Anne; Boza, Gabriella; Falchero, L.; Fournel, P.; Egenod, T.; Toffart, Anne‐Claire; Leiber, Nathalie; Dô, Pascal; Gervais, Radj

doi:10.1016/j.lungcan.2015.05.005

Cited by 18 publications

(13 citation statements)

References 29 publications

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“…The paper by VISSER et al [7], however, is the first to show the predictive properties of baseline reduced eGFR and reduced renal function during therapy for a (further) reduction in renal function due to pemetrexed. This is in line with a similar French study which had shown that renal toxicity was the main reason for interruption of treatment with pemetrexed and bevacizumab [17].…”

supporting

confidence: 91%

Optimisation of chemotherapy in the era of immunotherapy

Boosman

Burgers

2018

Eur Respir J

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]. Even in the era of immunotherapy and personalised medicine, chemotherapy remains a cornerstone in the treatment of nonsmall cell lung cancer (NSCLC) [1]. Chemotherapy improves the length and quality of life of patients with metastatic disease for tumours both with and without oncogenic drivers. Chemotherapy in combination with checkpoint inhibitors is about to become the most effective first-line therapy for NSCLC [2]. Also in the adjuvant setting, i.e. adding chemotherapy after surgery, chemotherapy improves survival with an absolute increase of 4% at 5 years [3].

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supporting

confidence: 91%

Optimisation of chemotherapy in the era of immunotherapy

Boosman

Burgers

2018

Eur Respir J

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“…4 Several retrospective studies had already described a higher incidence (17%-21%) of renal impairment with pemetrexed. 5,6 In this prospective cohort study by our group, frequencies of approximately 30% for acute kidney disease (AKD) and up to 20% for treatment discontinuation were reported during pemetrexed maintenance treatment. 7 As platinum, pemetrexed, and pembrolizumab are now often combined, it becomes a challenge to distinguish between chemotherapy-and pembrolizumab-induced renal adverse events.…”

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confidence: 99%

Renal Toxicity From Pemetrexed and Pembrolizumab in the Era of Combination Therapy in Patients With Metastatic Nonsquamous Cell NSCLC

Dumoulin

Visser

Cornelissen

et al. 2020

Journal of Thoracic Oncology

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The combination of chemotherapy and immune checkpoint inhibition (ICI) therapy is the current standard of care for most patients who are fit to undergo treatment for metastatic NSCLC. With this combination, renal toxicity was slightly higher than with chemotherapy alone in initial clinical trials. However, in recent realworld data, loss of kidney function is reported to be more frequent. Both chemotherapy and ICI therapy can induce renal impairment, although the mechanism of renal damage is different. Renal injury from chemotherapy is often ascribed to acute tubular injury and necrosis, whereas the main mechanism of injury caused by ICI therapy is acute tubulointerstitial nephritis. In cases of concomitant use of chemotherapy and ICI therapy, distinguishing the cause of renal failure is a challenge. Discriminating between these two causes is of utmost importance, as it would help assess which drug can be safely continued and which drug must be halted. This review aims to describe the underlying mechanisms of the renal adverse effects caused by chemotherapy and ICI therapy, leading to a suggested diagnostic and treatment algorithm on the basis of clinical, laboratory, radiographic, and pathologic parameters. This algorithm could serve as a supportive tool for clinicians to diagnose the underlying cause of acute kidney injury in patients treated with the combination of chemotherapy and immunotherapy.

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“…The risk of nephrotoxicity during treatment with pemetrexed is reported as 1%-5%, although data on this subject are mostly derived from case reports and relatively small studies. [25][26][27][28][29][30][31] Therefore, a subgroup analysis on patients receiving a cisplatin/ pemetrexed chemotherapy regimen was carried out. No significant differences in renal function or on the incidence of nephrotoxicity were found (Appendix S1).…”

Section: Discussionmentioning

confidence: 99%

The effect of rapid infusion of cisplatin on nephrotoxicity in patients with lung carcinoma

et al. 2018

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Summary What is known and objective The use of cisplatin in the treatment of lung carcinoma is limited by nephrotoxicity. The aim of this study was to determine whether the incidence of nephrotoxicity in patients with lung carcinoma is affected by the infusion rate of cisplatin (rapid infusion of cisplatin in 1 hour compared to regular infusion in 3 hours). Methods This observational, retrospective study was performed on patients diagnosed with non‐small‐cell lung carcinoma (NSCLC), small‐cell lung carcinoma (SCLC) or mesothelioma receiving a cisplatin‐containing chemotherapy regimen. Patients were divided into two cohorts (infusion of cisplatin in 1 hour vs 3 hours) based on the starting date of the chemotherapy regimen. The primary objectives were the difference in renal function after three cycles of chemotherapy and the incidence of nephrotoxicity. To assess nephrotoxicity, both the incidence of acute kidney injury (AKI) grade 1 and the maximum decrease in estimated glomerular filtration rate (eGFR) were determined. Results A total of 230 lung carcinoma patients with a cisplatin‐containing chemotherapy regimen were included. Baseline characteristics were similar for the rapid and regular infusion cohorts, except for type of lung carcinoma, chemotherapy regimen and prevalence of hypertension. There was no significant difference in renal function between rapid infusion of cisplatin and regular infusion of cisplatin (eGFR 86.1 mL/min [71.0‐96.3] vs 87.9 mL/min [71.6‐97.3]; P = 0.938). The incidence of AKI grade 1 was not significantly different between rapid and regular infusion of cisplatin (29.3% vs 29.8%; P = 0.932). The maximum decrease in eGFR was 14.8 mL/min in the rapid infusion cohort and 17.7 mL/min in the regular infusion cohort (P = 0.364). What is new and conclusion The incidence of nephrotoxicity after repeated infusion of cisplatin was not affected by the infusion rate of cisplatin. Therefore, a 1‐hour infusion of cisplatin is a safe and feasible method, which may potentially shorten duration of hospital admittance and enable treating patients in the outpatient setting.

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Renal insufficiency is the leading cause of double maintenance (bevacizumab and pemetrexed) discontinuation for toxicity to advanced non-small cell lung cancer in real world setting

Cited by 18 publications

References 29 publications

Optimisation of chemotherapy in the era of immunotherapy

Optimisation of chemotherapy in the era of immunotherapy

Renal Toxicity From Pemetrexed and Pembrolizumab in the Era of Combination Therapy in Patients With Metastatic Nonsquamous Cell NSCLC

The effect of rapid infusion of cisplatin on nephrotoxicity in patients with lung carcinoma

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