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[Cancer Treatment-induced Changes in Renal Function in Patients with Tumors - Update on Current Knowledge]
Background:
Renal abnormalities associated with malignancy are common with renal impairment occurring in about 60% of patients with tumors. Kidney disease may occur as a result of direct or indirect effects of tumors on kidneys and the urinary tract. Systematic oncology treatment can affect renal function in two ways, via direct toxic effects on kidney structure and indirectly via dehydration or tumor lysis syndrome. Since 2004, the Food and Drug Administration has approved a number of potentially nephrotoxic chemotherapeutics, targeted drugs, and immunotherapeutics for the treatment of solid tumors.
Aim:
This article provides an overview of the latest information on the nephrotoxicity associated with the use of new drugs.
Conclusion:
Despite the development of new drug treatments, including targeted therapy and immunotherapy, the risk of kidney involvement persists. The mechanisms of action of these new drugs are different from those of classical chemotherapy, and their use is usually associated with only mild to moderate side effects. In clinical trials, patients with pre-existing renal insufficiency are not present in most cases. Deterioration of renal function may significantly affect the treatment strategy and therefore careful renal function monitoring should be an integral part of each clinical trial.Key words: renal failure - toxicity - immunotherapy - chemotherapySubmitted: 7. 7. 2017Accepted: 7. 9. 2017 The authors declare they have no potential conflicts of interest concerning drugs, products, or services used in the study. The Editorial Board declares that the manuscript met the ICMJE recommendation for biomedical papers.
Insights
New cancer treatments like immunotherapy and targeted therapy can still harm the kidneys. Careful monitoring of renal function is crucial during cancer treatment to manage potential kidney toxicity.
Area of Science:
- Oncology
- Nephrology
- Pharmacology
Background:
- Renal abnormalities are common in cancer patients, with significant renal impairment affecting many.
- Tumors and cancer treatments can directly or indirectly cause kidney damage.
- Newer cancer therapies, including targeted drugs and immunotherapies, have been approved since 2004.
Purpose of the Study:
- To review current knowledge on kidney toxicity associated with novel cancer therapeutics.
- To highlight the evolving landscape of drug-induced kidney injury in oncology.
Main Methods:
- Literature review of recent studies on nephrotoxicity of new cancer drugs.
- Analysis of drug mechanisms and their impact on renal function.
- Examination of clinical trial data regarding renal outcomes.
Main Results:
- Despite advancements, kidney involvement remains a risk with new cancer treatments.
- Novel therapies like targeted therapy and immunotherapy generally show mild to moderate renal side effects compared to traditional chemotherapy.
- Limited data exists on patients with pre-existing renal insufficiency in clinical trials.
Conclusions:
- Kidney toxicity is an ongoing concern with modern cancer therapies.
- Careful monitoring of renal function is essential throughout cancer treatment.
- Integrating renal function assessment into clinical trials is vital for patient safety and treatment efficacy.
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