HOSHINO Junichi
   Department   School of Medicine(Tokyo Women's Medical University Hospital), School of Medicine
   Position   Professor and Division head
Article types Original article
Language English
Peer review Non peer reviewed
Title がん薬物療法時の腎障害診療ガイドライン2022(第2章)　腎機能障害患者に対するがん薬物療法の適応と投与方法(Chapter 2: indications and dosing of anticancer drug therapy in patients with impaired kidney function, from clinical practice guidelines for the management of kidney injury during anticancer drug therapy 2022)
Journal Formal name：International Journal of Clinical Oncology
Abbreviation：Int J Clin Oncol
ISSN code：14377772/13419625
Domestic / ForeginForegin
Publisher シュプリンガー・ジャパン(株)
Volume, Issue, Page 28(10),pp.1298-1314
Author and coauthor Nishiyama Hiroyuki, Inoue Takamitsu, Koizumi Yuichi, Kobayashi Yusuke, Kitamura Hiroshi, Yamamoto Kazuhiro,
Takeda Takashi, Yamamoto Takehito, Yamamoto Ryohei, Matsubara Takeshi, Hoshino Junichi, Yanagita Motoko,
The committee of Clinical practice guidelines for the management of kidney disease during anticance
Publication date 2023/10/28
Summary This comprehensive review discusses the dosing strategies of cancer treatment drugs for patients with impaired kidney function, specifically those with chronic kidney disease (CKD), undergoing hemodialysis, and kidney transplant recipients. CKD patients often necessitate dose adjustments of chemotherapeutic agents, e.g., platinum preparations, pyrimidine fluoride antimetabolites, antifolate agents, molecularly targeted agents, and bone-modifying agents, to prevent drug accumulation and toxicity due to diminished renal clearance of the administered drugs and their metabolites. In hemodialysis patients, factors such as drug removal from hemodialysis and altered pharmacokinetics demand careful optimization of anticancer drug therapy, including dose adjustment and timing of administration. While free cisplatin is removed by hemodialysis, most of the tissue- and protein-bound cisplatin remains in the body and rebound cisplatin elevations are observed after hemodialysis. It is not recommended hemodialysis for drug removal, regardless of timing. Kidney transplant patients encounter unique challenges in cancer treatment, as maintaining the balance between reduction of immunosuppression, switching to mTOR inhibitors, and considering potential drug interactions with chemotherapeutic agents and immunosuppressants are crucial for preventing graft rejection and achieving optimal oncologic outcomes. The review underscores the importance of personalized, patient-centric approaches to anticancer drug therapy in patients with impaired kidney function.
DOI 10.1007/s10147-023-02377-z
Document No. XA19140003<Pre 医中誌>
PMID 37572198