Characterization of renal injury in non‐squamous non‐small cell lung cancer patients treated with pemetrexed: A single‐center retrospective study

Abstract Introduction Pemetrexed is a key therapeutic agent for advanced non‐squamous non‐small cell lung cancer (Nsq‐NSCLC), yet it is associated with renal toxicity. This study aims to elucidate the incidence, risk factors, and survival impact of renal injury in patients with Nsq‐NSCLC treated wit...

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Main Authors: Yang Wu, Kang Miao, Minjiang Chen, Yan Xu, Wei Zhong, Hanping Wang, Xiaoyan Si, Xiaotong Zhang, Li Zhang, Jing Zhao, Mengzhao Wang
Format: Article
Language:English
Published: Wiley 2024-12-01
Series:Thoracic Cancer
Subjects:
Online Access:https://doi.org/10.1111/1759-7714.15470
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author Yang Wu
Kang Miao
Minjiang Chen
Yan Xu
Wei Zhong
Hanping Wang
Xiaoyan Si
Xiaotong Zhang
Li Zhang
Jing Zhao
Mengzhao Wang
author_facet Yang Wu
Kang Miao
Minjiang Chen
Yan Xu
Wei Zhong
Hanping Wang
Xiaoyan Si
Xiaotong Zhang
Li Zhang
Jing Zhao
Mengzhao Wang
author_sort Yang Wu
collection DOAJ
description Abstract Introduction Pemetrexed is a key therapeutic agent for advanced non‐squamous non‐small cell lung cancer (Nsq‐NSCLC), yet it is associated with renal toxicity. This study aims to elucidate the incidence, risk factors, and survival impact of renal injury in patients with Nsq‐NSCLC treated with pemetrexed. Methods We conducted a retrospective study including 136 patients with Nsq‐NSCLC treated with pemetrexed. Data on demographics, renal function, progression‐free survival (PFS), and overall survival (OS) were collected. Renal injury was defined as a reduction above 25% in estimated glomerular filtration rate (eGFR) from baseline. Its associated risk factors were analyzed using logistic regression, and impact on survival was analyzed using log‐rank test. The creatinine clearance rate (CCr) was calculated, and a CCr < 45 mL/min served as a contraindication for continuing pemetrexed. Results The study found a 31.6% (43/136) incidence of renal injury, with 9.6% (13/136) having CCr < 45 mL/min and discontinuing pemetrexed. Univariate and multivariate analyses identified factors significantly associated with increased renal injury risk including older age, use of cisplatin, and higher number of pemetrexed cycles. The patients with renal injury had a median PFS (mPFS) of 13.5 months and a median OS (mOS) of 36.0 months, while the patients without had an mPFS of 9.0 months and an mOS of 35.0 months, and these differences were not statistically significant. Conclusion Renal injury is a considerable complication in patients with Nsq‐NSCLC undergoing pemetrexed treatment, with age, platinum type, and pemetrexed treatment cycles as key risk factors. These findings highlight the necessity for careful renal monitoring in this patient population.
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spelling doaj-art-0d5d4e2c1f10469fb67293d7fd52fab62025-08-20T01:56:42ZengWileyThoracic Cancer1759-77061759-77142024-12-0115352474248510.1111/1759-7714.15470Characterization of renal injury in non‐squamous non‐small cell lung cancer patients treated with pemetrexed: A single‐center retrospective studyYang Wu0Kang Miao1Minjiang Chen2Yan Xu3Wei Zhong4Hanping Wang5Xiaoyan Si6Xiaotong Zhang7Li Zhang8Jing Zhao9Mengzhao Wang10Department of Pulmonary and Critical Care Medicine, Peking Union Medical College Hospital, Peking Union Medical College Hospital College Chinese Academy of Medical Sciences Beijing ChinaDepartment of Pulmonary and Critical Care Medicine, Peking Union Medical College Hospital, Peking Union Medical College Hospital College Chinese Academy of Medical Sciences Beijing ChinaDepartment of Pulmonary and Critical Care Medicine, Peking Union Medical College Hospital, Peking Union Medical College Hospital College Chinese Academy of Medical Sciences Beijing ChinaDepartment of Pulmonary and Critical Care Medicine, Peking Union Medical College Hospital, Peking Union Medical College Hospital College Chinese Academy of Medical Sciences Beijing ChinaDepartment of Pulmonary and Critical Care Medicine, Peking Union Medical College Hospital, Peking Union Medical College Hospital College Chinese Academy of Medical Sciences Beijing ChinaDepartment of Pulmonary and Critical Care Medicine, Peking Union Medical College Hospital, Peking Union Medical College Hospital College Chinese Academy of Medical Sciences Beijing ChinaDepartment of Pulmonary and Critical Care Medicine, Peking Union Medical College Hospital, Peking Union Medical College Hospital College Chinese Academy of Medical Sciences Beijing ChinaDepartment of Pulmonary and Critical Care Medicine, Peking Union Medical College Hospital, Peking Union Medical College Hospital College Chinese Academy of Medical Sciences Beijing ChinaDepartment of Pulmonary and Critical Care Medicine, Peking Union Medical College Hospital, Peking Union Medical College Hospital College Chinese Academy of Medical Sciences Beijing ChinaDepartment of Pulmonary and Critical Care Medicine, Peking Union Medical College Hospital, Peking Union Medical College Hospital College Chinese Academy of Medical Sciences Beijing ChinaDepartment of Pulmonary and Critical Care Medicine, Peking Union Medical College Hospital, Peking Union Medical College Hospital College Chinese Academy of Medical Sciences Beijing ChinaAbstract Introduction Pemetrexed is a key therapeutic agent for advanced non‐squamous non‐small cell lung cancer (Nsq‐NSCLC), yet it is associated with renal toxicity. This study aims to elucidate the incidence, risk factors, and survival impact of renal injury in patients with Nsq‐NSCLC treated with pemetrexed. Methods We conducted a retrospective study including 136 patients with Nsq‐NSCLC treated with pemetrexed. Data on demographics, renal function, progression‐free survival (PFS), and overall survival (OS) were collected. Renal injury was defined as a reduction above 25% in estimated glomerular filtration rate (eGFR) from baseline. Its associated risk factors were analyzed using logistic regression, and impact on survival was analyzed using log‐rank test. The creatinine clearance rate (CCr) was calculated, and a CCr < 45 mL/min served as a contraindication for continuing pemetrexed. Results The study found a 31.6% (43/136) incidence of renal injury, with 9.6% (13/136) having CCr < 45 mL/min and discontinuing pemetrexed. Univariate and multivariate analyses identified factors significantly associated with increased renal injury risk including older age, use of cisplatin, and higher number of pemetrexed cycles. The patients with renal injury had a median PFS (mPFS) of 13.5 months and a median OS (mOS) of 36.0 months, while the patients without had an mPFS of 9.0 months and an mOS of 35.0 months, and these differences were not statistically significant. Conclusion Renal injury is a considerable complication in patients with Nsq‐NSCLC undergoing pemetrexed treatment, with age, platinum type, and pemetrexed treatment cycles as key risk factors. These findings highlight the necessity for careful renal monitoring in this patient population.https://doi.org/10.1111/1759-7714.15470Nsq‐NSCLCpemetrexedrenal injurysurvival
spellingShingle Yang Wu
Kang Miao
Minjiang Chen
Yan Xu
Wei Zhong
Hanping Wang
Xiaoyan Si
Xiaotong Zhang
Li Zhang
Jing Zhao
Mengzhao Wang
Characterization of renal injury in non‐squamous non‐small cell lung cancer patients treated with pemetrexed: A single‐center retrospective study
Thoracic Cancer
Nsq‐NSCLC
pemetrexed
renal injury
survival
title Characterization of renal injury in non‐squamous non‐small cell lung cancer patients treated with pemetrexed: A single‐center retrospective study
title_full Characterization of renal injury in non‐squamous non‐small cell lung cancer patients treated with pemetrexed: A single‐center retrospective study
title_fullStr Characterization of renal injury in non‐squamous non‐small cell lung cancer patients treated with pemetrexed: A single‐center retrospective study
title_full_unstemmed Characterization of renal injury in non‐squamous non‐small cell lung cancer patients treated with pemetrexed: A single‐center retrospective study
title_short Characterization of renal injury in non‐squamous non‐small cell lung cancer patients treated with pemetrexed: A single‐center retrospective study
title_sort characterization of renal injury in non squamous non small cell lung cancer patients treated with pemetrexed a single center retrospective study
topic Nsq‐NSCLC
pemetrexed
renal injury
survival
url https://doi.org/10.1111/1759-7714.15470
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