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Decrease in estimated glomerular filtration rates in non-small cell lung cancer patients treated with crizotinib
Yakup Iriagac1, Eyyup Cavdar1, Kubilay Karaboyun1
1Department of Medical Oncology, Faculty of Medicine, Tekirdag Namik Kemal University, Tekirdag, Turkey.
Introduction:
Crizotinib is a tyrosine kinase inhibitor used in patients with non-small cell lung cancer, and there are uncertainties about its effect on kidney function. In this study, it was aimed to document the possible adverse effect of the drug on kidney functions.
Materials And Methods:
The estimated glomerular filtration rates (eGFRs) of the patients were calculated by creatinine-based Chronic Kidney Disease Epidemiology Collaboration and compared by months using the paired samples t-test. Kaplan-Meier survival method was used for progression-free survival and overall survival (OS) analysis.
Results:
Twenty-six patients who received crizotinib were included in the study, and the median progression-free survival time with crizotinib was 14.2 months and the median OS time was 27.4 months. There was a significant reduction of eGFR after the 1st month of crizotinib treatment when compared to the rate before treatment initiation (P < 0.001). The eGFR values at the end of the 1st month and the 2nd month of treatment and the 2nd and 3rd months of treatment were statistically similar (P = 0.086, P = 0.663; respectively). This decrease in eGFR values was reversible, and there was no difference detected between pretreatment and posttreatment discontinuation (P = 0.100).
Conclusion:
A reversible decrease in renal functions was detected in patients using crizotinib. When the literature data are examined, it is thought that the reason for this decrease may be related to the increase in renal inflammation or a pseudo decrease due to the decrease in creatinine excretion. When evaluating renal functions in these patients, using noncreatine-based (iothalamate, etc.) calculations can give more accurate results.
Insights
Crizotinib treatment for non-small cell lung cancer can cause a temporary decline in kidney function, as measured by estimated glomerular filtration rate (eGFR). This reduction in eGFR is reversible after discontinuing the drug.
Area of Science:
- Oncology
- Nephrology
- Pharmacology
Background:
- Crizotinib is a tyrosine kinase inhibitor used for non-small cell lung cancer (NSCLC).
- Uncertainty exists regarding crizotinib's impact on renal function.
- This study investigated the adverse effects of crizotinib on kidney function in NSCLC patients.
Purpose of the Study:
- To evaluate the effect of crizotinib on kidney function in NSCLC patients.
- To document potential adverse effects on renal parameters.
- To assess the reversibility of any observed changes in kidney function.
Main Methods:
- Estimated glomerular filtration rates (eGFR) were calculated using the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation.
- Creatinine-based eGFR values were compared pre-treatment and at monthly intervals during treatment.
- Paired samples t-test and Kaplan-Meier survival analysis were employed.
Main Results:
- Twenty-six NSCLC patients receiving crizotinib were analyzed.
- A significant reduction in eGFR was observed after the first month of crizotinib treatment (P < 0.001).
- The decrease in eGFR was reversible upon treatment discontinuation, with no significant difference compared to pre-treatment levels (P = 0.100).
Conclusions:
- Crizotinib treatment is associated with a reversible decrease in renal function.
- The observed decline may be due to renal inflammation or pseudo-decrease from altered creatinine excretion.
- Non-creatinine-based methods for eGFR calculation may provide more accurate renal function assessment in patients on crizotinib.
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