Skip Navigation



Annals of Oncology Advance Access published online on July 13, 2007
Annals of Oncology, doi:10.1093/annonc/mdm011
This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow All Versions of this Article:
18/8/1314    most recent
mdm011v1
Right arrow E-letters: Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when E-letters are posted
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My Personal Archive
Right arrow Download to citation manager
Right arrowRequest Permissions
Right arrow Disclaimer
Google Scholar
Right arrow Articles by Launay-Vacher, V
Right arrow Articles by Aapro, M
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Launay-Vacher, V
Right arrow Articles by Aapro, M
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us  
What's this?

© 2007 European Society for Medical Oncology

review

Renal insufficiency in elderly cancer patients: International Society of Geriatric Oncology clinical practice recommendations

V Launay-Vacher1, E Chatelut2, SM Lichtman3, H Wildiers4, C Steer5 and M Aapro6,*

1 Hôpital Pitié-Salpêtrière, Paris
2 Université Paul-Sabatier and Institut Claudius-Regaud, Toulouse, France
3 Memorial Sloan-Kettering Cancer Center, New York, NY, USA
4 University Hospital Gasthuisberg, Leuven, Belgium
5 Murray Valley Private Hospital, Wodonga, Australia
6 Clinique de Genolier, Geneva, Switzerland

*Correspondence to: Dr M. S. Aapro, Doyen IMO Clinique de Genolier, 1 route du Muids, 1272 Genolier, Switzerland. Tel: +41-223669106; Fax: +41-223669131; E-mail: maapro{at}genolier.net

Background: Elderly cancer patients commonly have renal function decline. This warrants particular caution during the administration of renally excreted cancer drugs or those with established nephrotoxicity.

Design: An International Society for Geriatric Oncology task force was formed to discuss treatment recommendations for this group of patients.

Results: Before drug therapy, the assessment and optimization of hydration status and evaluation of renal function is required. Serum creatinine alone is insufficient as a means of evaluating renal function, and creatinine clearance should at least be calculated in every patient by the abbreviated modification of diet in renal disease or Cockcroft-Gault equations. In the extremes of obesity and cachexia and at very high and low creatinine values, no single tool is really accurate. In these patients, the best estimate of glomerular filtration rate is provided by direct methods such as 51Cr-EDTA or inulin measurement. Within each drug class, preference may be given to agents less likely to be influenced by renal clearance, which are minimally nephrotoxic, or for which appropriate methods of prevention for renal toxicity exist. Coadministration of known nephrotoxic drugs should be avoided or minimized.

Conclusions: Future trials should be designed to present data in a way that allows evaluation of the contribution of renal function to toxicity and efficacy.

cancer, clinical practice recommendations, creatinine clearance, elderly, renal insufficiency, SCr

Received for publication October 11, 2006. Revision received November 21, 2006. Accepted for publication November 27, 2006.


Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us    What's this?


This article has been cited by other articles:


Home page
 Am Soc Clin Oncol Ed BookHome page
S. M. Lichtman
Pharmacology of Antineoplastic Agents for Older Patients
ASCO Educational Book, January 1, 2008; 2008(1): 210 - 214.
[Abstract] [Full Text] [PDF]


Disclaimer:
Please note that abstracts for content published before 1996 were created through digital scanning and may therefore not exactly replicate the text of the original print issues. All efforts have been made to ensure accuracy, but the Publisher will not be held responsible for any remaining inaccuracies. If you require any further clarification, please contact our Customer Services Department.