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Preloading magnesium attenuates cisplatin-associated nephrotoxicity: pilot randomized controlled trial (PRAGMATIC
S Suppadungsuk1, W Phitakwatchara2, T Reungwetwattana3
1Chakri Naruebodindra Medical Institute, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Samut Prakan, Thailand.
ESMO Open
|December 25, 2021
Summary
Magnesium supplementation before cisplatin chemotherapy significantly reduced the incidence of cisplatin-associated acute kidney disease (cis-AKD) in head and neck cancer patients. This pilot study suggests magnesium preloading is a safe and effective strategy to mitigate cisplatin nephrotoxicity.
Area of Science:
- Oncology
- Nephrology
- Pharmacology
Background:
- Cisplatin is a cornerstone chemotherapy for head and neck cancers.
- Nephrotoxicity is a significant dose-limiting side effect of cisplatin.
- Magnesium supplementation has shown potential in reducing cisplatin-induced kidney damage in prior studies.
Purpose of the Study:
- To investigate the efficacy of magnesium preloading in preventing cisplatin-associated nephrotoxicity.
- To evaluate the impact of magnesium on acute kidney injury (AKI) and acute kidney disease (AKD) in patients receiving weekly low-dose cisplatin.
- To assess the safety and tolerability of magnesium preloading in this patient population.
Main Methods:
- A prospective, single-blinded, randomized controlled trial was conducted.
- 30 head and neck cancer patients were randomized into a control group (saline + KCl) and a magnesium group (saline + KCl + magnesium).
- Patients received weekly cisplatin 40 mg/m² for 7-8 weeks, with pre-chemotherapy infusions.
Main Results:
- The incidence of cisplatin-associated acute kidney disease (cis-AKD) was significantly lower in the magnesium group (6.7%) compared to the control group (46.7%).
- The time to develop cis-AKD was significantly shorter in the control group.
- Tumor response rates and survival were comparable between the groups.
Conclusions:
- Magnesium preloading is a safe and effective strategy for reducing cis-AKD in head and neck cancer patients undergoing cisplatin chemotherapy.
- This pilot study provides encouraging evidence that warrants confirmation in larger randomized controlled trials.
- Magnesium supplementation represents a promising approach to mitigate cisplatin-induced nephrotoxicity.
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