Optimization of cisplatin doses in a testicular cancer patient with acute renal failure

Although testicular cancers are highly curable malignancies, conventional cisplatin based therapy often causes important toxicities, not often easily manageable. Nephrotoxicity occurs in almost all patients, and is potentialized in patients suffering from renal failure. Monitoring of residual levels...

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Bibliographic Details
Published in:Journal of oncology pharmacy practice 2011-09, Vol.17 (3), p.265-269
Main Authors: Pouliquen, A-L, Bousquet, G, Le Maignan, C, Bauer, C, Lejri, N, Misset, J-L, Lokiec, F
Format: Article
Language:English
Subjects:
Acute Kidney Injury - blood
Acute Kidney Injury - chemically induced
Acute Kidney Injury - therapy
Antineoplastic Combined Chemotherapy Protocols - administration & dosage
Antineoplastic Combined Chemotherapy Protocols - adverse effects
Antineoplastic Combined Chemotherapy Protocols - pharmacokinetics
Bleomycin - administration & dosage
Bleomycin - adverse effects
Bleomycin - pharmacokinetics
Case management
Chemotherapy
Cisplatin - administration & dosage
Cisplatin - adverse effects
Cisplatin - pharmacokinetics
Drug Dosage Calculations
Drug dosages
Drug Monitoring
Etoposide - administration & dosage
Etoposide - adverse effects
Etoposide - pharmacokinetics
Fatal Outcome
Humans
Kidney diseases
Male
Middle Aged
Renal Dialysis
Testicular cancer
Testicular Neoplasms - drug therapy
Time Factors
Treatment Outcome
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Summary:Although testicular cancers are highly curable malignancies, conventional cisplatin based therapy often causes important toxicities, not often easily manageable. Nephrotoxicity occurs in almost all patients, and is potentialized in patients suffering from renal failure. Monitoring of residual levels of unbound platinum was used to define guidelines for cisplatin administration. Monitoring of cisplatin was initiated in a patient treated for metastatic testicular cancer and acute renal failure. Reduced doses of cisplatin were first administered in conjunction with hemodialysis. Unbound and total platinum levels were determined by flameless atomic absorption spectrophotometry. The data found allowed us to adapt and increase sequentially cisplatin doses, accordingly with the renal function. Full regimen doses were eventually administered when useful renal function returned. This simple approach may be useful in monitoring cisplatin administration during acute renal failure.
ISSN:1078-1552
1477-092X
DOI:10.1177/1078155209351761