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. 2019 Dec;10(12):2282-2288.
doi: 10.1111/1759-7714.13222. Epub 2019 Oct 21.

Retrospective cohort study on the safety and efficacy of docetaxel in Japanese non-small cell lung cancer patients with nondialysis chronic kidney disease stage 3b or higher

Satoshi Anai  1 , Ritsu Ibusuki  1 , Tomoaki Takao  1 , Yuko Sakurai  1 , Junko Hisasue  1 , Yoichi Takaki  1 , Naohiko Hara  1
Affiliations

Retrospective cohort study on the safety and efficacy of docetaxel in Japanese non-small cell lung cancer patients with nondialysis chronic kidney disease stage 3b or higher

Satoshi Anai et al. Thorac Cancer. 2019 Dec.

Abstract

Background: It has been reported that 20% of lung cancer patients have renal impairment caused by chronic kidney disease (CKD). Since docetaxel is predominantly excreted by the hepatobiliary system, it is administered to non-small cell lung cancer (NSCLC) patients with renal impairment. However, few clinical data are available on the toxicity and efficacy of docetaxel for patients with nondialysis renal impairment. Furthermore, some cases of tubular nephrotoxicity caused by docetaxel in NSCLC patients have been reported. Therefore, a retrospective cohort study was conducted to assess the influence of nondialysis CKD on the toxicity and efficacy of docetaxel in NSCLC patients.

Methods: NSCLC patients who received docetaxel were assessed for renal function, occurrence of adverse events and treatment efficacy.

Results: A total of 34 NSCLC patients who received docetaxel were studied. Eight (23.5%) patients had nondialysis CKD stage 3b or higher, with an estimated glomerular filtration rate (eGFR) <45 mL/min/1.73 m2 . Although the differences were not statistically significant, the starting dose of docetaxel (mg/m2 ) was lower (60 mg/m2 ; 37.5% vs. 69.2%) in patients with an eGFR <45 than that in patients with an eGFR ≥45. No significant association was observed between pretreatment eGFR and hematological and nonhematological toxicities. No significant difference was observed in the disease control rate (62.5% vs. 65.4%, P = 1.000) or in the median overall survival (10.7 vs. 11.7, P = 0.735) between patients with an eGFR <45 and those with an eGFR ≥45.

Conclusion: Docetaxel is a reasonable option for NSCLC patients with nondialysis CKD stage 3b or higher. Dose reduction of docetaxel is also a possibility for NSCLC patients with CKD stage 3b or higher.

Keywords: Chronic kidney disease; docetaxel; estimated glomerular filtration rate; non-small-cell lung cancer.

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Figures

Figure 1
Figure 1
Changes in serum creatinine concentration (a), in eGFR (b) and in Ccr (c) during docetaxel chemotherapy in NSCLC patients with an eGFR <45 and an eGFR ≥45 mL/min/1.73 m2. Bars indicate mean values. P‐values were determined using an unpaired Student's t‐test.
Figure 2
Figure 2
Kaplan‐Meier survival curve for NSCLC patients with an eGFR <45 and an eGFR ≥45 mL/min/1.73 m2. NA, not available.
See this image and copyright information in PMC

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