Targeted and immune therapies among patients with metastatic renal carcinoma undergoing hemodialysis: A systemic review.
Semin Oncol
; 47(2-3): 103-116, 2020.
Article
in En
| MEDLINE
| ID: mdl-32522380
ABSTRACT
BACKGROUND:
Patients with severe renal impairment or undergoing hemodialysis are usually excluded from clinical trials. Available data regarding safety and activity of systemic therapies (ST) in hemodialyzed patients are scarce.METHODS:
Clinical data were searched through PubMed database until April 2020 according to PRISMA criteria. Efficacy, safety and pharmacokinetic (PK) assessment of ST were reported.RESULTS:
Among 270 references, 56 reports were evaluated in full text 41 were included for efficacy and 42 for safety analysis (sunitinib nâ¯=â¯68, bevacizumab nâ¯=â¯6, everolimus nâ¯=â¯28, temsirolimus nâ¯=â¯17, sorafenib nâ¯=â¯55, axitinib nâ¯=â¯13, pazopanib nâ¯=â¯13, nivolumab nâ¯=â¯18, cabozantinib nâ¯=â¯0, lenvatinib nâ¯=â¯0, and ipilimumab nâ¯=â¯0). Twelve of the reports included PK assessment among dialyzed patients. Hemodialysis did not seem to modify the expected efficacy and safety of each compound among patients undergoing hemodialysis. PK assessments were not modified in comparison with a population not undergoing dialysis.CONCLUSION:
Targeted and Immune therapies seem to be effective and can be used among patients undergoing hemodialysis. Due to frailty and comorbidities associated to chronic hemodialysis enhanced vigilance for these therapies within this specific population is recommended. Dedicated prospective clinical trials would definitely help to obtain data with a higher level of evidence.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Carcinoma, Renal Cell
/
Renal Dialysis
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Molecular Targeted Therapy
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Immunotherapy
/
Kidney Neoplasms
Type of study:
Systematic_reviews
Limits:
Female
/
Humans
/
Male
Language:
En
Journal:
Semin Oncol
Year:
2020
Document type:
Article