Reducing renal function assessment prior to platinum-based chemotherapy: a real-world evaluation

Area of Science:

• Oncology
• Nephrology
• Clinical Pharmacology

Background:

• Platinum-based chemotherapy is a cornerstone of cancer treatment but is associated with nephrotoxicity.
• Current guidelines lack specific recommendations for the frequency of renal function monitoring during platinum-based chemotherapy.

Purpose of the Study:

• To determine the median time to a clinically significant dosage adjustment (>10%) in patients receiving cisplatin or carboplatin due to changes in renal function.
• To identify variables that influence changes in renal function during platinum-based chemotherapy.

Main Methods:

• Retrospective analysis of serial renal function assessments in platinum-treated cancer patients.
• Data extracted from electronic health records of two academic medical centers (2017-2019).

Main Results:

• 15% of cisplatin patients and 21% of carboplatin patients required dosage adjustments (>10%) due to renal function changes.
• Median time to renal function decline requiring adjustment was 67 days for cisplatin and 64 days for carboplatin.
• No significant difference in time to renal function decline between cisplatin and carboplatin regimens.

Conclusions:

• Clinically relevant dose adjustments for platinum-based chemotherapy due to declining renal function occur at a median of 64 days.
• Data support recommending renal function assessment every 3 weeks for clinically stable patients receiving platinum-based chemotherapy.