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Management of targeted therapies in hemodialysis patients |
Bulletin du Cancer. Volume 99, Number 3, 381-8, Mars 2012, Synthèse
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 Résumé
Texte intégral
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Author(s) : Nicolas Janus, Vincent Launay-Vacher, Gilbert Deray, Mohamed Shariful Islam, Antoine Thyss, Juliette Thariat |
Summary : <\;p>The increased incidence of cancer in dialysis patients has been discussed since the mid 1970s. Furthermore, the emergence of targeted therapies (TT) requires oncologists, nephrologists and pharmacists to question themselves about the handling of these new classes of drugs in dialysis patients. While the cytotoxic drugs have been used in oncology for a long time, these new molecules are recent and clinical studies on their management in dialysis patients are missing.<\;/p><\;p>We reviewed the international literature on the pharmacokinetics, efficacy, tolerance and dosage adjustment of TT used in hemodialysis cancer patients, using the following keywords: kidney\; renal\; dialysis\; hemodialysis\; end-stage renal disease and the name of each drug.<\;/p><\;p>As described for cytotoxic drugs, there are only case reports or series published in the international literature. However, it is possible to propose some recommendations on TT handling in dialysis patients. It is not necessary to adapt the dose of monoclonal antibodies in dialysis patients. But it is important to considerer that this “class effect” is not true for all the other classes of drugs. In fact, the pharmacokinetic of tyrosine kinase inhibitors varies from drug to drug.<\;/p><\;p>The use of TT is possible in dialysis patients. However, many drugs require special attention in dialysis. In addition, because these drugs are new, it is important that oncologists, nephrologists, and pharmacists remain up to date about the management of TT in dialysis patients.<\;/p> |
Keywords : cytotoxic drugs, targeted therapies, hemodialysis, pharmacokinetics, dosing recommendations |
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