Lindsay L Peterson1, Arti Hurria2, Tao Feng2, Supriya G Mohile3, Cynthia Owusu4, Heidi D Klepin5, Cary P Gross6, Stuart M Lichtman7, Ajeet Gajra8, Ilya Glezerman7, Vani Katheria2, Laura Zavala2, David D Smith2, Can-Lan Sun2, William P Tew7. 1. Washington University School of Medicine, St. Louis, MO, United States. Electronic address: llpeterson@wustl.edu. 2. City of Hope Comprehensive Cancer Center and Beckman Research Institute, Duarte, CA, United States. 3. University of Rochester, Rochester, NY, United States. 4. Case Western Reserve University, Cleveland, OH, United States. 5. Wake Forest University School of Medicine, Winston-Salem, NC, United States. 6. Yale Comprehensive Cancer Center, New Haven, CT, United States. 7. Memorial Sloan-Kettering Cancer Center, United States. 8. State University of New York Upstate Medical University and Veterans Administration Medical Center, Syracuse, NY, United States.
Abstract
PURPOSE: To evaluate the association between renal function (RF) and chemotherapy-related toxicity (CRT) in older adults with cancer and to compare the effect of different RF formulas and body weight measurements on this association. METHODS: This is a secondary analysis of data from a prospective multicenter study of patients ≥ age 65 who were starting a new chemotherapy regimen. RF was estimated with 4 formulas (modified Jelliffe [Jelliffe], Cockcroft-Gault [CG], Wright, and Modification of Diet in Renal Disease [MDRD]), using actual, ideal and adjusted body weights for 492 patients. The association between baseline RF and grade 3-5 CRT was evaluated by unconditional logistic regression. RESULTS: As a continuous variable, decreased creatinine clearance (CrCl) calculated by CG with actual body weight was associated with increased odds of CRT (OR 1.12, P<0.01; 95% CI 1.04-1.20) indicating that on average for every 10mL/min decrease in CrCl the odds of CRT increased by 12%. Very low RF (in the lowest 10%) with all formulas (CG, Jelliffe, Wright and MDRD) was associated with increased odds for CRT. This association is independent of the type of chemotherapy received (those requiring dose adjustment for renal function vs not). Neither primary dose reduction nor chemotherapy duration was associated with CRT. Serum creatinine alone was not associated with increased odds of CRT (OR 0.67, P=0.15). CONCLUSIONS: Decreased RF is associated with increased odds of CRT and should be considered when assessing risk of CRT in older adults with cancer. Serum creatinine alone is not adequate for risk assessment.
PURPOSE: To evaluate the association between renal function (RF) and chemotherapy-related toxicity (CRT) in older adults with cancer and to compare the effect of different RF formulas and body weight measurements on this association. METHODS: This is a secondary analysis of data from a prospective multicenter study of patients ≥ age 65 who were starting a new chemotherapy regimen. RF was estimated with 4 formulas (modified Jelliffe [Jelliffe], Cockcroft-Gault [CG], Wright, and Modification of Diet in Renal Disease [MDRD]), using actual, ideal and adjusted body weights for 492 patients. The association between baseline RF and grade 3-5 CRT was evaluated by unconditional logistic regression. RESULTS: As a continuous variable, decreased creatinine clearance (CrCl) calculated by CG with actual body weight was associated with increased odds of CRT (OR 1.12, P<0.01; 95% CI 1.04-1.20) indicating that on average for every 10mL/min decrease in CrCl the odds of CRT increased by 12%. Very low RF (in the lowest 10%) with all formulas (CG, Jelliffe, Wright and MDRD) was associated with increased odds for CRT. This association is independent of the type of chemotherapy received (those requiring dose adjustment for renal function vs not). Neither primary dose reduction nor chemotherapy duration was associated with CRT. Serum creatinine alone was not associated with increased odds of CRT (OR 0.67, P=0.15). CONCLUSIONS: Decreased RF is associated with increased odds of CRT and should be considered when assessing risk of CRT in older adults with cancer. Serum creatinine alone is not adequate for risk assessment.
Authors: Ajeet Gajra; Heidi D Klepin; Tao Feng; William P Tew; Supriya G Mohile; Cynthia Owusu; Cary P Gross; Stuart M Lichtman; Tanya M Wildes; Andrew E Chapman; Efrat Dotan; Vani Katheria; Laura Zavala; Chie Akiba; Arti Hurria Journal: J Geriatr Oncol Date: 2015-02-07 Impact factor: 3.599
Authors: Arti Hurria; Kayo Togawa; Supriya G Mohile; Cynthia Owusu; Heidi D Klepin; Cary P Gross; Stuart M Lichtman; Ajeet Gajra; Smita Bhatia; Vani Katheria; Shira Klapper; Kurt Hansen; Rupal Ramani; Mark Lachs; F Lennie Wong; William P Tew Journal: J Clin Oncol Date: 2011-08-01 Impact factor: 44.544
Authors: Stuart M Lichtman; Constance T Cirrincione; Arti Hurria; Aminah Jatoi; Maria Theodoulou; Antonio C Wolff; Julie Gralow; Daniel E Morganstern; Gustav Magrinat; Harvey Jay Cohen; Hyman B Muss Journal: J Clin Oncol Date: 2016-01-11 Impact factor: 44.544
Authors: Wendelin K Nelson; Richard N Formica; Dennis L Cooper; Peter E Schwartz; Thomas J Rutherford Journal: J Oncol Pharm Pract Date: 2012-02-13 Impact factor: 1.809
Authors: J Feliu; V Heredia-Soto; R Gironés; B Jiménez-Munarriz; J Saldaña; C Guillén-Ponce; M J Molina-Garrido Journal: Clin Transl Oncol Date: 2019-06-25 Impact factor: 3.405
Authors: Heidi D Klepin; Can-Lan Sun; David D Smith; Rawad Elias; Kelly M Trevino; Ashley Leak Bryant; Daneng Li; Christian Nelson; William P Tew; Supriya G Mohile; Ajeet Gajra; Cynthia Owusu; Cary Gross; Stuart M Lichtman; Vani V Katheria; Hyman B Muss; Andrew E Chapman; Harvey Jay Cohen; Arti Hurria; William Dale Journal: JCO Oncol Pract Date: 2021-04-21