Skip to main content
Erschienen in: Cancer Chemotherapy and Pharmacology 4/2011

01.04.2011 | Original Article

Renal safety and efficacy of cisplatin-based chemotherapy in patients with a solitary kidney after nephroureterectomy for urothelial carcinoma of the upper urinary tract

verfasst von: Kang Su Cho, Jae Young Joung, Ho Kyung Seo, In-Chang Cho, Han Soo Chung, Jinsoo Chung, Kang Hyun Lee

Erschienen in: Cancer Chemotherapy and Pharmacology | Ausgabe 4/2011

Einloggen, um Zugang zu erhalten

Abstract

Purpose

Little information is available about changes in renal function after cisplatin-based chemotherapy (CBCT) in patients with a solitary kidney. The authors evaluated the renal safety and efficacy of CBCT after nephroureterectomy for upper urinary tract-urothelial carcinoma (UUT-UC).

Methods

The data of patients who underwent nephroureterectomy for UUT-UC and received CBCT for adjuvant and/or palliative treatment were reviewed. Renal function changes and renal function–related adverse events (AEs) were analyzed, and objective tumor responses were assessed.

Results

Sixty patients were enrolled, and a median of 6 cycles (1–22) of CBCT were administered. After the 3rd cycle of CBCT, serum creatinine levels were significantly higher than at baseline, whereas mean creatinine clearances and estimated glomerular filtration rates were significantly lower. These renal function indicators also tended to be lower than baseline after the 6th–21st cycles, but these decreases were not significant. Significant AEs (≥grade 2) occurred in 10 patients (16.7%), and serious AEs (≥grade 3) developed in two that required temporary hemodialysis. Univariate analysis revealed that a low estimated glomerular filtration rate at baseline was related to the occurrence of a significant renal AE with borderline significance (Hazard ratio = 3.284, P = 0.100). The overall tumor response rate was 30.2%, and tumor response rates of 1st, 2nd, and 3rd line therapies were 36.4, 25.0, and 12.5%, respectively.

Conclusions

Cisplatin-based chemotherapy can be administered in the majority of patients with UUT-UC with a solitary kidney after nephroureterectomy without inducing a serious AE, and provides acceptable efficacy.
Literatur
1.
Zurück zum Zitat Hall MC, Womack S, Sagalowsky AI, Carmody T, Erickstad MD, Roehrborn CG (1998) Prognostic factors, recurrence, and survival in transitional cell carcinoma of the upper urinary tract: a 30-year experience in 252 patients. Urology 52:594–601PubMedCrossRef Hall MC, Womack S, Sagalowsky AI, Carmody T, Erickstad MD, Roehrborn CG (1998) Prognostic factors, recurrence, and survival in transitional cell carcinoma of the upper urinary tract: a 30-year experience in 252 patients. Urology 52:594–601PubMedCrossRef
2.
Zurück zum Zitat Langner C, Hutterer G, Chromecki T, Winkelmayer I, Rehak P, Zigeuner R (2006) pT classification, grade, and vascular invasion as prognostic indicators in urothelial carcinoma of the upper urinary tract. Mod Pathol 19:272–279PubMedCrossRef Langner C, Hutterer G, Chromecki T, Winkelmayer I, Rehak P, Zigeuner R (2006) pT classification, grade, and vascular invasion as prognostic indicators in urothelial carcinoma of the upper urinary tract. Mod Pathol 19:272–279PubMedCrossRef
3.
Zurück zum Zitat Margulis V, Shariat SF, Matin SF, Kamat AM, Zigeuner R, Kikuchi E et al (2009) Outcomes of radical nephroureterectomy: a series from the Upper Tract Urothelial Carcinoma Collaboration. Cancer 115:1224–1233PubMedCrossRef Margulis V, Shariat SF, Matin SF, Kamat AM, Zigeuner R, Kikuchi E et al (2009) Outcomes of radical nephroureterectomy: a series from the Upper Tract Urothelial Carcinoma Collaboration. Cancer 115:1224–1233PubMedCrossRef
4.
Zurück zum Zitat Hellenthal NJ, Shariat SF, Margulis V, Karakiewicz PI, Roscigno M, Bolenz C et al (2009) Adjuvant chemotherapy for high risk upper tract urothelial carcinoma: results from the Upper Tract Urothelial Carcinoma Collaboration. J Urol 182:900–906PubMedCrossRef Hellenthal NJ, Shariat SF, Margulis V, Karakiewicz PI, Roscigno M, Bolenz C et al (2009) Adjuvant chemotherapy for high risk upper tract urothelial carcinoma: results from the Upper Tract Urothelial Carcinoma Collaboration. J Urol 182:900–906PubMedCrossRef
5.
Zurück zum Zitat Uhm JE, Lim HY, Kim WS, Choi HY, Lee HM, Park BB et al (2007) Paclitaxel with cisplatin as salvage treatment for patients with previously treated advanced transitional cell carcinoma of the urothelial tract. Neoplasia 9:18–22PubMedCrossRef Uhm JE, Lim HY, Kim WS, Choi HY, Lee HM, Park BB et al (2007) Paclitaxel with cisplatin as salvage treatment for patients with previously treated advanced transitional cell carcinoma of the urothelial tract. Neoplasia 9:18–22PubMedCrossRef
6.
Zurück zum Zitat von der Maase H, Hansen SW, Roberts JT, Dogliotti L, Oliver T, Moore MJ et al (2000) Gemcitabine and cisplatin versus methotrexate, vinblastine, doxorubicin, and cisplatin in advanced or metastatic bladder cancer: results of a large, randomized, multinational, multicenter, phase III study. J Clin Oncol 18:3068–3077PubMed von der Maase H, Hansen SW, Roberts JT, Dogliotti L, Oliver T, Moore MJ et al (2000) Gemcitabine and cisplatin versus methotrexate, vinblastine, doxorubicin, and cisplatin in advanced or metastatic bladder cancer: results of a large, randomized, multinational, multicenter, phase III study. J Clin Oncol 18:3068–3077PubMed
7.
Zurück zum Zitat Loehrer PJ Sr, Einhorn LH, Elson PJ, Crawford ED, Kuebler P, Tannock I et al (1992) A randomized comparison of cisplatin alone or in combination with methotrexate, vinblastine, and doxorubicin in patients with metastatic urothelial carcinoma: a cooperative group study. J Clin Oncol 10:1066–1073PubMed Loehrer PJ Sr, Einhorn LH, Elson PJ, Crawford ED, Kuebler P, Tannock I et al (1992) A randomized comparison of cisplatin alone or in combination with methotrexate, vinblastine, and doxorubicin in patients with metastatic urothelial carcinoma: a cooperative group study. J Clin Oncol 10:1066–1073PubMed
8.
Zurück zum Zitat Poggio ED, Wang X, Weinstein DM, Issa N, Dennis VW, Braun WE et al (2006) Assessing glomerular filtration rate by estimation equations in kidney transplant recipients. Am J Transplant 6:100–108PubMedCrossRef Poggio ED, Wang X, Weinstein DM, Issa N, Dennis VW, Braun WE et al (2006) Assessing glomerular filtration rate by estimation equations in kidney transplant recipients. Am J Transplant 6:100–108PubMedCrossRef
10.
Zurück zum Zitat Therasse P, Arbuck SG, Eisenhauer EA, Wanders J, Kaplan RS, Rubinstein L et al (2000) New guidelines to evaluate the response to treatment in solid tumors. European Organization for Research and Treatment of Cancer, National Cancer Institute of the United States, National Cancer Institute of Canada. J Natl Cancer Inst 92:205–216PubMedCrossRef Therasse P, Arbuck SG, Eisenhauer EA, Wanders J, Kaplan RS, Rubinstein L et al (2000) New guidelines to evaluate the response to treatment in solid tumors. European Organization for Research and Treatment of Cancer, National Cancer Institute of the United States, National Cancer Institute of Canada. J Natl Cancer Inst 92:205–216PubMedCrossRef
11.
Zurück zum Zitat Huang WC, Levey AS, Serio AM, Snyder M, Vickers AJ, Raj GV et al (2006) Chronic kidney disease after nephrectomy in patients with renal cortical tumours: a retrospective cohort study. Lancet Oncol 7:735–740PubMedCrossRef Huang WC, Levey AS, Serio AM, Snyder M, Vickers AJ, Raj GV et al (2006) Chronic kidney disease after nephrectomy in patients with renal cortical tumours: a retrospective cohort study. Lancet Oncol 7:735–740PubMedCrossRef
12.
Zurück zum Zitat Lucas SM, Stern JM, Adibi M, Zeltser IS, Cadeddu JA, Raj GV (2008) Renal function outcomes in patients treated for renal masses smaller than 4 cm by ablative and extirpative techniques. J Urol 179:75–79 (discussion 79–80)PubMedCrossRef Lucas SM, Stern JM, Adibi M, Zeltser IS, Cadeddu JA, Raj GV (2008) Renal function outcomes in patients treated for renal masses smaller than 4 cm by ablative and extirpative techniques. J Urol 179:75–79 (discussion 79–80)PubMedCrossRef
13.
Zurück zum Zitat Dash A, Galsky MD, Vickers AJ, Serio AM, Koppie TM, Dalbagni G et al (2006) Impact of renal impairment on eligibility for adjuvant cisplatin-based chemotherapy in patients with urothelial carcinoma of the bladder. Cancer 107:506–513PubMedCrossRef Dash A, Galsky MD, Vickers AJ, Serio AM, Koppie TM, Dalbagni G et al (2006) Impact of renal impairment on eligibility for adjuvant cisplatin-based chemotherapy in patients with urothelial carcinoma of the bladder. Cancer 107:506–513PubMedCrossRef
14.
Zurück zum Zitat Raj GV, Iasonos A, Herr H, Donat SM (2006) Formulas calculating creatinine clearance are inadequate for determining eligibility for cisplatin-based chemotherapy in bladder cancer. J Clin Oncol 24:3095–3100PubMedCrossRef Raj GV, Iasonos A, Herr H, Donat SM (2006) Formulas calculating creatinine clearance are inadequate for determining eligibility for cisplatin-based chemotherapy in bladder cancer. J Clin Oncol 24:3095–3100PubMedCrossRef
15.
Zurück zum Zitat Kintzel PE, Dorr RT (1995) Anticancer drug renal toxicity and elimination: dosing guidelines for altered renal function. Cancer Treat Rev 21:33–64PubMedCrossRef Kintzel PE, Dorr RT (1995) Anticancer drug renal toxicity and elimination: dosing guidelines for altered renal function. Cancer Treat Rev 21:33–64PubMedCrossRef
16.
17.
Zurück zum Zitat Garcia JA, Dreicer R (2006) Systemic chemotherapy for advanced bladder cancer: update and controversies. J Clin Oncol 24:5545–5551PubMedCrossRef Garcia JA, Dreicer R (2006) Systemic chemotherapy for advanced bladder cancer: update and controversies. J Clin Oncol 24:5545–5551PubMedCrossRef
18.
Zurück zum Zitat Petrioli R, Frediani B, Manganelli A, Barbanti G, De Capua B, De Lauretis A et al (1996) Comparison between a cisplatin-containing regimen and a carboplatin-containing regimen for recurrent or metastatic bladder cancer patients. A randomized phase II study. Cancer 77:344–351PubMedCrossRef Petrioli R, Frediani B, Manganelli A, Barbanti G, De Capua B, De Lauretis A et al (1996) Comparison between a cisplatin-containing regimen and a carboplatin-containing regimen for recurrent or metastatic bladder cancer patients. A randomized phase II study. Cancer 77:344–351PubMedCrossRef
19.
Zurück zum Zitat Bellmunt J, Ribas A, Eres N, Albanell J, Almanza C, Bermejo B et al (1997) Carboplatin-based versus cisplatin-based chemotherapy in the treatment of surgically incurable advanced bladder carcinoma. Cancer 80:1966–1972PubMedCrossRef Bellmunt J, Ribas A, Eres N, Albanell J, Almanza C, Bermejo B et al (1997) Carboplatin-based versus cisplatin-based chemotherapy in the treatment of surgically incurable advanced bladder carcinoma. Cancer 80:1966–1972PubMedCrossRef
20.
Zurück zum Zitat Dogliotti L, Carteni G, Siena S, Bertetto O, Martoni A, Bono A et al (2007) Gemcitabine plus cisplatin versus gemcitabine plus carboplatin as first-line chemotherapy in advanced transitional cell carcinoma of the urothelium: results of a randomized phase 2 trial. Eur Urol 52:134–141PubMedCrossRef Dogliotti L, Carteni G, Siena S, Bertetto O, Martoni A, Bono A et al (2007) Gemcitabine plus cisplatin versus gemcitabine plus carboplatin as first-line chemotherapy in advanced transitional cell carcinoma of the urothelium: results of a randomized phase 2 trial. Eur Urol 52:134–141PubMedCrossRef
21.
Zurück zum Zitat Culine S (2007) Chemotherapy for advanced transitional cell carcinoma of the urothelium: cisplatin or carboplatin? Eur Urol 52:9–10PubMedCrossRef Culine S (2007) Chemotherapy for advanced transitional cell carcinoma of the urothelium: cisplatin or carboplatin? Eur Urol 52:9–10PubMedCrossRef
22.
Zurück zum Zitat Herget-Rosenthal S, Bokenkamp A, Hofmann W (2007) How to estimate GFR-serum creatinine, serum cystatin C or equations? Clin Biochem 40:153–161PubMedCrossRef Herget-Rosenthal S, Bokenkamp A, Hofmann W (2007) How to estimate GFR-serum creatinine, serum cystatin C or equations? Clin Biochem 40:153–161PubMedCrossRef
23.
Zurück zum Zitat Sambataro M, Thomaseth K, Pacini G, Robaudo C, Carraro A, Bruseghin M et al (1996) Plasma clearance rate of 51Cr-EDTA provides a precise and convenient technique for measurement of glomerular filtration rate in diabetic humans. J Am Soc Nephrol 7:118–127PubMed Sambataro M, Thomaseth K, Pacini G, Robaudo C, Carraro A, Bruseghin M et al (1996) Plasma clearance rate of 51Cr-EDTA provides a precise and convenient technique for measurement of glomerular filtration rate in diabetic humans. J Am Soc Nephrol 7:118–127PubMed
24.
Zurück zum Zitat Quasthoff S, Hartung HP (2002) Chemotherapy-induced peripheral neuropathy. J Neurol 249:9–17PubMedCrossRef Quasthoff S, Hartung HP (2002) Chemotherapy-induced peripheral neuropathy. J Neurol 249:9–17PubMedCrossRef
25.
Zurück zum Zitat Rybak LP (2007) Mechanisms of cisplatin ototoxicity and progress in otoprotection. Curr Opin Otolaryngol Head Neck Surg 15:364–369PubMedCrossRef Rybak LP (2007) Mechanisms of cisplatin ototoxicity and progress in otoprotection. Curr Opin Otolaryngol Head Neck Surg 15:364–369PubMedCrossRef
26.
Zurück zum Zitat Han KS, Joung JY, Kim TS, Jeong IG, Seo HK, Chung J et al (2008) Methotrexate, vinblastine, doxorubicin and cisplatin combination regimen as salvage chemotherapy for patients with advanced or metastatic transitional cell carcinoma after failure of gemcitabine and cisplatin chemotherapy. Br J Cancer 98:86–90PubMedCrossRef Han KS, Joung JY, Kim TS, Jeong IG, Seo HK, Chung J et al (2008) Methotrexate, vinblastine, doxorubicin and cisplatin combination regimen as salvage chemotherapy for patients with advanced or metastatic transitional cell carcinoma after failure of gemcitabine and cisplatin chemotherapy. Br J Cancer 98:86–90PubMedCrossRef
Metadaten
Titel
Renal safety and efficacy of cisplatin-based chemotherapy in patients with a solitary kidney after nephroureterectomy for urothelial carcinoma of the upper urinary tract
verfasst von
Kang Su Cho
Jae Young Joung
Ho Kyung Seo
In-Chang Cho
Han Soo Chung
Jinsoo Chung
Kang Hyun Lee
Publikationsdatum
01.04.2011
Verlag
Springer-Verlag
Erschienen in
Cancer Chemotherapy and Pharmacology / Ausgabe 4/2011
Print ISSN: 0344-5704
Elektronische ISSN: 1432-0843
DOI
https://doi.org/10.1007/s00280-010-1349-2

Weitere Artikel der Ausgabe 4/2011

Cancer Chemotherapy and Pharmacology 4/2011 Zur Ausgabe

Erhebliches Risiko für Kehlkopfkrebs bei mäßiger Dysplasie

29.05.2024 Larynxkarzinom Nachrichten

Fast ein Viertel der Personen mit mäßig dysplastischen Stimmlippenläsionen entwickelt einen Kehlkopftumor. Solche Personen benötigen daher eine besonders enge ärztliche Überwachung.

15% bedauern gewählte Blasenkrebs-Therapie

29.05.2024 Urothelkarzinom Nachrichten

Ob Patienten und Patientinnen mit neu diagnostiziertem Blasenkrebs ein Jahr später Bedauern über die Therapieentscheidung empfinden, wird einer Studie aus England zufolge von der Radikalität und dem Erfolg des Eingriffs beeinflusst.

Erhöhtes Risiko fürs Herz unter Checkpointhemmer-Therapie

28.05.2024 Nebenwirkungen der Krebstherapie Nachrichten

Kardiotoxische Nebenwirkungen einer Therapie mit Immuncheckpointhemmern mögen selten sein – wenn sie aber auftreten, wird es für Patienten oft lebensgefährlich. Voruntersuchung und Monitoring sind daher obligat.

Costims – das nächste heiße Ding in der Krebstherapie?

28.05.2024 Onkologische Immuntherapie Nachrichten

„Kalte“ Tumoren werden heiß – CD28-kostimulatorische Antikörper sollen dies ermöglichen. Am besten könnten diese in Kombination mit BiTEs und Checkpointhemmern wirken. Erste klinische Studien laufen bereits.

Update Onkologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.