Dose Adjustment of Oxaliplatin Based on Renal Function in Patients With Metastatic Colorectal Cancer

Anticancer Res. 2020 Apr;40(4):2379-2386. doi: 10.21873/anticanres.14207.

Abstract

Background/aim: The effect of renal dysfunction on the toxicity and efficacy of oxaliplatin remains unclear. We investigated the association between creatinine clearance (Ccr), a marker of renal function, and the toxicity and efficacy of oxaliplatin in patients with metastatic colorectal cancer (mCRC).

Patients and methods: Patients with mCRC who received oxaliplatin-based chemotherapy as first-line treatment were included in this study. Primary outcome was peripheral neuropathy (Grade ≥2), while secondary outcomes included neutropenia (Grade ≥3), thrombocytopenia (Grade ≥2) and overall survival (OS).

Results: A total of 145 patients with mCRC were eligible. Incidence rates of peripheral neuropathy (Grade ≥2), neutropenia (Grade ≥3) and thrombocytopenia (Grade ≥2) were 30.3%, 37.2% and 16.6%, respectively, and median OS was 29.1 months. Cox proportional hazards analysis indicated that there was no significant relationship between Ccr and any adverse event, or between Ccr and OS.

Conclusion: Dose reduction of oxaliplatin based on Ccr is not recommended in patients with mCRC.

Keywords: Oxaliplatin. renal function; colorectal neoplasms; peripheral neuropathy; survival.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Antineoplastic Combined Chemotherapy Protocols / adverse effects
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
  • Colorectal Neoplasms / drug therapy*
  • Colorectal Neoplasms / metabolism
  • Colorectal Neoplasms / pathology
  • Creatinine / pharmacokinetics
  • Drug Administration Schedule
  • Female
  • Humans
  • Kaplan-Meier Estimate
  • Male
  • Metabolic Clearance Rate
  • Middle Aged
  • Neoplasm Metastasis
  • Neutropenia / chemically induced
  • Oxaliplatin / administration & dosage
  • Oxaliplatin / adverse effects
  • Peripheral Nervous System Diseases / chemically induced

Substances

  • Oxaliplatin
  • Creatinine