Chemotherapy for Patients with Renal Dysfunction

K. Suyama, Y. Miura, T. Takano, H. Iwase
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引用次数: 3

Abstract

Significant progress has been made in systemic chemotherapies for advanced cancer patients. Historically, the main anticancer drugs were cytotoxic agents, but recently, other agents such as molecularly-targeted therapies and immune checkpoint inhibitors have been introduced into clinical practice, and these agents have begun to achieve mainstream usage. The rapid development of novel anticancer drugs has forced clinicians to consider the effects of these chemotherapy agents in high-risk patients with liver or renal dysfunction, those undergoing dialysis and the elderly. Currently, there are no clear guidelines describing the best practices for anticancer drug administration in patients with renal dysfunction. However, the theory that renal dysfunction affects the ability of patients to cope with anticancer therapies is understandable compared with liver dysfunction or other risk factors. That is why there has always been an indication for dose adjustments for patients with renal dysfunction. In this review, recommended dose adjustments in cases of renal dysfunction are discussed based on the latest information on anticancer drugs.
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肾功能不全患者的化疗
在晚期癌症患者的全身化疗方面取得了重大进展。历史上,主要的抗癌药物是细胞毒性药物,但最近,分子靶向疗法和免疫检查点抑制剂等其他药物已被引入临床实践,这些药物已开始获得主流使用。新型抗癌药物的快速发展迫使临床医生考虑这些化疗药物对肝肾功能障碍的高危患者、接受透析的患者和老年人的影响。目前,还没有明确的指南来描述肾功能不全患者服用抗癌药物的最佳实践。然而,与肝功能障碍或其他风险因素相比,肾功能障碍影响患者应对抗癌治疗能力的理论是可以理解的。这就是为什么肾功能不全患者的剂量调整一直有适应症的原因。在这篇综述中,根据抗癌药物的最新信息,讨论了肾功能障碍病例的推荐剂量调整。
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