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A Syngeneic Mouse Model of Metastatic Renal Cell Carcinoma for Quantitative and Longitudinal Assessment of Preclinical Therapies
Published on: April 12, 2017
Changes in Renal Function of Patients with Metastatic Renal Cell Carcinoma During Treatment with Molecular-Targeted
Hideaki Miyake1, Mototsugu Muramaki2, Satoshi Imai2
1Division of Urology, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan. hideakimiyake@hotmail.com.
Background:
Impairment of renal function is a serious issue that should be considered in patients undergoing treatment with molecular-targeted agents for metastatic renal cell carcinoma (mRCC).
Aims:
The objective of this study was to assess the impact of molecular-targeted therapy on changes in renal function among patients with mRCC.
Patients And Methods:
The study included 408 mRCC patients treated with sunitinib, sorafenib, axitinib, everolimus and/or temsirolimus. Among these, 185, 128 and 95 received molecular-targeted agents as first-line (group 1), second-line (group 2) and third-line (group 3) therapy, respectively.
Results:
No significant differences between the estimated glomerular filtration rate (eGFR) at baseline and that at the end of molecular-targeted therapy were noted among the three groups of patients. In addition, there were no significant differences between eGFR prior to the introduction of molecular-targeted therapy and that at the end of therapy across agents and lines of targeted therapy, with the exception of patients treated with axitinib and everolimus in second-line and third-line therapy, respectively. In group 1, a reduction in eGFR of >10 % from baseline was independently associated with performance status, hypertension and treatment duration, while in groups 2 and 3, only treatment duration was independently related to a reduction in eGFR of >10 %.
Conclusions:
It appears that renal function in patients with mRCC is not markedly impaired by molecular-targeted therapies, irrespective of the specific agents introduced; however, it may be necessary to pay special attention to deterioration in renal function when molecular-targeted therapy is continued for longer periods.
Insights
Molecular-targeted therapies generally do not impair renal function in metastatic renal cell carcinoma (mRCC) patients. However, prolonged treatment duration may necessitate closer monitoring for changes in kidney function.
Area of Science:
- Nephrology
- Oncology
- Pharmacology
Background:
- Renal function impairment is a significant concern for patients with metastatic renal cell carcinoma (mRCC) receiving molecular-targeted agents.
- Monitoring kidney function is crucial during mRCC treatment.
Purpose of the Study:
- To evaluate the impact of molecular-targeted therapy on renal function in mRCC patients.
- To assess changes in estimated glomerular filtration rate (eGFR) during targeted therapy.
Main Methods:
- Retrospective analysis of 408 mRCC patients treated with sunitinib, sorafenib, axitinib, everolimus, or temsirolimus.
- Patients categorized into first-line, second-line, and third-line therapy groups.
- Comparison of eGFR at baseline, pre-therapy, and end-of-therapy.
Main Results:
- No significant overall differences in eGFR were observed between baseline and end-of-therapy across treatment lines.
- A >10% reduction in eGFR was associated with performance status, hypertension, and treatment duration in first-line therapy.
- Treatment duration was the primary factor linked to eGFR reduction in second- and third-line therapies, with exceptions for axitinib and everolimus.
Conclusions:
- Molecular-targeted therapies show minimal impact on renal function in mRCC patients.
- Extended treatment duration warrants careful monitoring for potential renal function decline.
- Individual agent effects on renal function require consideration, particularly with axitinib and everolimus in later treatment lines.
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