The Use of Hemoadsorption in Cancer-Related Complications

Patients with metastatic cancer are at risk of drug-related toxicity or disease-related complications leading to the development of organ failure such as rhabdomyolysis-associated acute kidney injury (AKI), liver failure, and multi-organ failure, often precipitated by endotoxinemia and sepsis. In cases of systemic hyperinflammatory response, mediated by cytokines, to specific treatment with CAR-T-cell therapy or in sepsis with or without the development of AKI, we do not have an effective and specific target molecule-oriented therapy.

Over the past few decades, numerous experimental and clinical studies have investigated the efficacy of extracorporeal blood purification technologies in the treatment of specific indications like sepsis and septic shock. In this review article, our goal was to show the possibility of using different hemoadsorbers in specific indications in patients with cancer-related complications, their reported effectiveness in certain indications and the possibility of applying it to cancer patients not only as a last-stand therapy but as well as preventing the development of specific organ or multi-organ failure.

Currently, multiple forms of extracorporeal blood purification are available that may have benefit in patients with cancer-related complications. Despite a strong rationale for extracorporeal blood purification, many physicians are still reluctant introducing hemoadsorption as a recommended routine due to still insufficient evidence, mostly as a result of inadequate numbers of published randomized controlled trials. Nevertheless, the application of hemoadsorption should be the same for cancer-related complications as well as it is for other patients because, in most cases, we aim to remove the same target molecules.