Feasibility of combination chemotherapy with cisplatin and etoposide for haemodialysis patients with lung cancer

Cancer chemotherapy for haemodialysis patients has never been established. To elucidate the feasibility of cisplatin-based combination chemotherapy for haemodialysis patients with lung cancer, a dose escalation study was conducted. Five haemodialysis patients with lung cancer were treated with cisplatin and etoposide. A starting dose of 40 mg m−2 of cisplatin on day 1 and 50 mg m−2 of etoposide on days 1, 3 and 5 were administered as the first course for the first patient. Membrane haemodialysis was regularly performed three times a week and soon after the completion of therapy. By monitoring toxicity and pharmacokinetics data, the dose was escalated course by course and patient by patient. Dose escalation was completed for the first two patients resulting in full-dose chemotherapy consisting of 80 mg m−2 of cisplatin on day 1 and 100 mg m−2 of etoposide on days 1, 3 and 5. Multiple courses of the full-dose chemotherapy were administered to the other three patients. Toxicity was manageable and tolerable for all. Pharmacokinetics data were comparable to those from patients with normal renal function, except for potential long-lasting higher levels of free platinum in the renal insufficiency group. In conclusion, this standard-dose combination chemotherapy was feasible even for haemodialysis patients.

[1]  M. Christian,et al.  [New guidelines to evaluate the response to treatment in solid tumors]. , 2000, Bulletin du cancer.

[2]  H. Sumitani,et al.  Carboplatin-based chemotherapy in patients undergoing hemodialysis. , 1996, Anticancer research.

[3]  R. Strife,et al.  Analysis of the anticancer drugs etoposide (VP 16-213) and teniposide (VM 26) by high-performance liquid chromatography with fluorescence detection. , 1981, Journal of chromatography.

[4]  J. Bull,et al.  Kinetics of cis‐dichlorodiammineplatinum , 1979, Clinical pharmacology and therapeutics.

[5]  D. Kerr,et al.  Successful use of cisplatin to treat metastatic seminoma during cisplatin‐induced acute renal failure , 1991, Cancer.

[6]  Z. Saliternik.  English abstract , 2018, Kielentutkimuksen menetelmiä I-IV.

[7]  Kiyoshi Yamaoka,et al.  Statistical moments in pharmacokinetics , 1978, Journal of Pharmacokinetics and Biopharmaceutics.

[8]  M. Fukuoka,et al.  [Studies on the appropriate administration of cisplatin based on pharmacokinetics and toxicity]. , 1987, Gan to kagaku ryoho. Cancer & chemotherapy.

[9]  D. Johnson,et al.  Evolution of cisplatin-based chemotherapy in non-small cell lung cancer: a historical perspective and the eastern cooperative oncology group experience. , 2000, Chest.

[10]  A. Guarino,et al.  Analysis of platinum in biological materials by flameless atomic absorption spectrophotometry. , 1977, Biochemical medicine.

[11]  D. Newell,et al.  Pharmacokinetically guided dosing of carboplatin and etoposide during peritoneal dialysis and haemodialysis. , 1996, British Journal of Cancer.

[12]  D. Osoba,et al.  VP-16 and cisplatin as first-line therapy for small-cell lung cancer. , 1985, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[13]  S. Sato,et al.  [A phase I study of VP-16-213 (VP, etoposide) by single and 5-day intravenous administration]. , 1986, Gan to kagaku ryoho. Cancer & chemotherapy.

[14]  W. V. van Oort,et al.  Pharmacokinetic evaluation of increasing dosages of etoposide in a chronic hemodialysis patient. , 1985, Cancer treatment reports.

[15]  T. Miyazaki,et al.  [Etoposide and cisplatin combination chemotherapy in a patient with small cell lung carcinoma under artificial hemodialysis]. , 1992, Gan to kagaku ryoho. Cancer & chemotherapy.

[16]  M. Blumenstein,et al.  Modulation of cytotoxicity of cytostatic drugs by hemodialysis in vitro and in vivo. , 1990, Cancer treatment reviews.

[17]  H. Kawane,et al.  [Squamous cell carcinoma of the lung detected during maintenance hemodialysis which reduced in size after combined CDDP chemotherapy]. , 1990, Nihon Kyobu Shikkan Gakkai zasshi.

[18]  T. F. Patton,et al.  Pharmacokinetics of non-protein-bound platinum species following administration of cis-dichlorodiammineplatinum(II). , 1979, Cancer treatment reports.

[19]  P. Boyle,et al.  Cancer in patients on dialysis for end-stage renal disease: an international collaborative study , 1999, The Lancet.

[20]  C. Stewart.  Use of etoposide in patients with organ dysfunction: pharmacokinetic and pharmacodynamic considerations , 2004, Cancer Chemotherapy and Pharmacology.