International Society of Geriatric Oncology (SIOG) recommendations for the adjustment of dosing in elderly cancer patients with renal insufficiency Journal Article
| Authors: | Lichtman, S. M.; Wildiers, H.; Launay-Vacher, V.; Steer, C.; Chatelut, E.; Aapro, M. |
| Article Title: | International Society of Geriatric Oncology (SIOG) recommendations for the adjustment of dosing in elderly cancer patients with renal insufficiency |
| Abstract: | A SIOG taskforce was formed to discuss best clinical practice for elderly cancer patients with renal insufficiency. This manuscript outlines recommended dosing adjustments for cancer drugs in this population according to renal function. Dosing adjustments have been made for drugs in current use which have recommendations in renal insufficiency and the elderly, focusing on drugs which are renally eliminated or are known to be nephrotoxic. Recommendations are based on pharmacokinetic and/or pharmacodynamic data where available. The taskforce recommend that before initiating therapy, some form of geriatric assessment should be conducted that includes evaluation of comorbidities and polypharmacy, hydration status and renal function (using available formulae). Within each drug class, it is sensible to use agents which are less likely to be influenced by renal clearance. Pharmacokinetic and pharmacodynamic data of anticancer agents in the elderly are needed in order to maximise efficacy whilst avoiding unacceptable toxicity. © 2006 Elsevier Ltd. All rights reserved. |
| Keywords: | cancer chemotherapy; aged; fludarabine; hydroxyurea; drug tolerability; neutropenia; cisplatin; fluorouracil; area under the curve; diarrhea; drug withdrawal; monotherapy; side effect; antineoplastic agents; capecitabine; gemcitabine; paclitaxel; cancer patient; cytarabine; methotrexate; temozolomide; topotecan; neurotoxicity; antineoplastic agent; clinical practice; neoplasms; colorectal cancer; carboplatin; dacarbazine; unindexed drug; multiple cycle treatment; multiple myeloma; nephrotoxicity; breast cancer; bone marrow suppression; etoposide; blood toxicity; vomiting; combination chemotherapy; cyclophosphamide; melphalan; creatinine blood level; kidney failure; urea nitrogen blood level; continuous infusion; bladder cancer; carmustine; ifosfamide; loading drug dose; prostate cancer; liver failure; kidney function; nonsteroid antiinflammatory agent; comorbidity; medical society; bleomycin; glomerulus filtration rate; kidney clearance; aging; drug bioavailability; acute lymphocytic leukemia; mitomycin; oxaliplatin; chronic lymphatic leukemia; pemetrexed; elderly; hemolytic uremic syndrome; hydration; uric acid blood level; drug interactions; zoledronic acid; drug exposure; creatinine clearance; cephalosporin; drug elimination; pamidronic acid; ibandronic acid; kidney dysfunction; raltitrexed; kidney blood flow; renal insufficiency; serum creatinine; clinical practice recommendations; dosing adjustments; acute kidney tubule necrosis |
| Journal Title: | European Journal of Cancer |
| Volume: | 43 |
| Issue: | 1 |
| ISSN: | 0959-8049 |
| Publisher: | Elsevier Inc. |
| Date Published: | 2007-01-01 |
| Start Page: | 14 |
| End Page: | 34 |
| Language: | English |
| DOI: | 10.1016/j.ejca.2006.11.004 |
| PUBMED: | 17222747 |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | --- - "Cited By (since 1996): 69" - "Export Date: 17 November 2011" - "CODEN: EJCAE" - "Source: Scopus" |
