Risk factors Associated with nephrotoxicity in cancer patients treated with oxaliplatin based chemotherapy

Abstract

Oxaliplatin, one of the platinum drugs, is an effective agent for treating gastrointestinal cancers, especially colorectal cancer, increasing incidence and one of the major causes of cancer patient deaths in Thailand. Nowadays, there are a few reports of the incidence of oxaliplatin nephrotoxicity. This study aimed to assess the incidence and risk factors associated with nephrotoxicity in cancer patients treated with oxaliplatin-based chemotherapy. All data were extracted from electronic medical records of patients aged 18 years who received oxaliplatin-containing regimens from the first until the last cycle at a medical school hospital in Bangkok in 2018. Results: A total of 64 patients were female (60.9%). The mean age was 57.8 ± 12.4 years. Most of the patients had gastrointestinal cancers (95.3%), and 68.8% had metastatic cancer. Nephrotoxicity was defined as an increase of Scr ≥ 25% from baseline. There were nine patients with nephrotoxicity (14.1%). Nephrotoxicity was reported in 4 patients (44.4%) in the first cycle. Nephrotoxicity was found in the patients with an ECOG PS status of 0 more than the other groups, about 36.4% (P = 0.031). Patients with kidney disease were more prominent in the nephrotoxicity group(75% VS 10%, P = 0.007). The total number of cycles administered was significantly associated with oxaliplatin nephrotoxicity (P = 0.015). The nephrotoxicity group received more cycles of chemotherapy (a median process was 9). In addition, three from nine patients had more than one episode of nephrotoxicity (33.3%). Conclusion: Although oxaliplatin nephrotoxicity has rarely been reported. This study found that one in seven of Thai cancer patients who underwent oxaliplatin-based chemotherapy had developed nephrotoxicity. Thus in practice, frequent monitoring of Scr should be done to detect and treat oxaliplatin nephrotoxicity early.