Hemodiafiltration and plasma levels of axitinib in a patient with metastatic renal clear cell carcinoma
Background: The standard treatment for metastatic renal cancer is based on vascular endothelial growth factor (VEGF) and mammalian target of rapamycin (mTor) inhibitors. Compared to other advanced tumors, the treatment of renal cancer is highly affected by impaired renal function; therefore, patient...
Main Authors: | , , , |
---|---|
Format: | Article |
Language: | English |
Published: |
Palacký University Olomouc, Faculty of Medicine and Dentistry
2018-11-01
|
Series: | Biomedical Papers |
Subjects: | |
Online Access: | https://biomed.papers.upol.cz/artkey/bio-201804-0014_hemodiafiltration_and_plasma_levels_of_axitinib_in_a_patient_with_metastatic_renal_clear_cell_carcinoma.php |
id |
doaj-1dd21da999274ce2830ac29558c3791b |
---|---|
record_format |
Article |
spelling |
doaj-1dd21da999274ce2830ac29558c3791b2020-11-25T02:55:52ZengPalacký University Olomouc, Faculty of Medicine and DentistryBiomedical Papers1213-81181804-75212018-11-01162433533910.5507/bp.2018.021bio-201804-0014Hemodiafiltration and plasma levels of axitinib in a patient with metastatic renal clear cell carcinomaJindrich Kopecky0Alena Ticha1Hana Janeckova2Bohuslav Melichar3Department of Clinical Oncology and Radiotherapy, University Hospital Hradec Kralove and Faculty of Medicine in Hradec Kralove, Charles University, Czech RepublicDepartment of Research and Development, University Hospital Hradec Kralove, Czech RepublicLaboratory for Inherited Metabolic Disorders, Department of Clinical Biochemistry, University Hospital Olomouc, Czech RepublicDepartment of Clinical Oncology and Radiotherapy, University Hospital Hradec Kralove and Faculty of Medicine in Hradec Kralove, Charles University, Czech RepublicBackground: The standard treatment for metastatic renal cancer is based on vascular endothelial growth factor (VEGF) and mammalian target of rapamycin (mTor) inhibitors. Compared to other advanced tumors, the treatment of renal cancer is highly affected by impaired renal function; therefore, patients with severe renal insufficiency, including patients on hemodialysis, are generally excluded from clinical trials. Case report: In the present manuscript we present the case of a renal cancer patient who underwent bilateral nephrectomy and received two lines of treatment. We hypothesized that axitinib, a tyrosine kinase inhibitor, would have a similar plasma concentration to patients without hemodialysis and that the levels before and after hemodiafiltration will not differ significantly, as observed in other targeted therapies. Conclusion: The observed axitinib concentrations were at least an order of magnitude lower than expected based on the literature and measurements in other patients. The present case report indicates a potential risk of axitinib underdosing in patients on hemodiafiltration with the standard dose; therefore, drug dosage may need to be corrected based on the plasma levels of axitinib.https://biomed.papers.upol.cz/artkey/bio-201804-0014_hemodiafiltration_and_plasma_levels_of_axitinib_in_a_patient_with_metastatic_renal_clear_cell_carcinoma.phpaxitinibrenal cancerchronic kidney failurehemodialysisprotein-tyrosine kinasesnephrectomy |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Jindrich Kopecky Alena Ticha Hana Janeckova Bohuslav Melichar |
spellingShingle |
Jindrich Kopecky Alena Ticha Hana Janeckova Bohuslav Melichar Hemodiafiltration and plasma levels of axitinib in a patient with metastatic renal clear cell carcinoma Biomedical Papers axitinib renal cancer chronic kidney failure hemodialysis protein-tyrosine kinases nephrectomy |
author_facet |
Jindrich Kopecky Alena Ticha Hana Janeckova Bohuslav Melichar |
author_sort |
Jindrich Kopecky |
title |
Hemodiafiltration and plasma levels of axitinib in a patient with metastatic renal clear cell carcinoma |
title_short |
Hemodiafiltration and plasma levels of axitinib in a patient with metastatic renal clear cell carcinoma |
title_full |
Hemodiafiltration and plasma levels of axitinib in a patient with metastatic renal clear cell carcinoma |
title_fullStr |
Hemodiafiltration and plasma levels of axitinib in a patient with metastatic renal clear cell carcinoma |
title_full_unstemmed |
Hemodiafiltration and plasma levels of axitinib in a patient with metastatic renal clear cell carcinoma |
title_sort |
hemodiafiltration and plasma levels of axitinib in a patient with metastatic renal clear cell carcinoma |
publisher |
Palacký University Olomouc, Faculty of Medicine and Dentistry |
series |
Biomedical Papers |
issn |
1213-8118 1804-7521 |
publishDate |
2018-11-01 |
description |
Background: The standard treatment for metastatic renal cancer is based on vascular endothelial growth factor (VEGF) and mammalian target of rapamycin (mTor) inhibitors. Compared to other advanced tumors, the treatment of renal cancer is highly affected by impaired renal function; therefore, patients with severe renal insufficiency, including patients on hemodialysis, are generally excluded from clinical trials. Case report: In the present manuscript we present the case of a renal cancer patient who underwent bilateral nephrectomy and received two lines of treatment. We hypothesized that axitinib, a tyrosine kinase inhibitor, would have a similar plasma concentration to patients without hemodialysis and that the levels before and after hemodiafiltration will not differ significantly, as observed in other targeted therapies. Conclusion: The observed axitinib concentrations were at least an order of magnitude lower than expected based on the literature and measurements in other patients. The present case report indicates a potential risk of axitinib underdosing in patients on hemodiafiltration with the standard dose; therefore, drug dosage may need to be corrected based on the plasma levels of axitinib. |
topic |
axitinib renal cancer chronic kidney failure hemodialysis protein-tyrosine kinases nephrectomy |
url |
https://biomed.papers.upol.cz/artkey/bio-201804-0014_hemodiafiltration_and_plasma_levels_of_axitinib_in_a_patient_with_metastatic_renal_clear_cell_carcinoma.php |
work_keys_str_mv |
AT jindrichkopecky hemodiafiltrationandplasmalevelsofaxitinibinapatientwithmetastaticrenalclearcellcarcinoma AT alenaticha hemodiafiltrationandplasmalevelsofaxitinibinapatientwithmetastaticrenalclearcellcarcinoma AT hanajaneckova hemodiafiltrationandplasmalevelsofaxitinibinapatientwithmetastaticrenalclearcellcarcinoma AT bohuslavmelichar hemodiafiltrationandplasmalevelsofaxitinibinapatientwithmetastaticrenalclearcellcarcinoma |
_version_ |
1724715705511706624 |