Hemodiafiltration and plasma levels of axitinib in a patient with metastatic renal clear cell carcinoma

Biomedical Papers of the Medical Faculty of the University Palacký, Olomouc, Czechoslovakia
Jindrich KopeckyMelichar Bohuslav

Abstract

The standard treatment for metastatic renal cancer is based on vascular endothelial growth factor (VEGF) and mammalian target of rapamycin (mTor) inhibitors. Compared to other advanced tumors, the treatment of renal cancer is highly affected by impaired renal function; therefore, patients with severe renal insufficiency, including patients on hemodialysis, are generally excluded from clinical trials. In the present manuscript we present the case of a renal cancer patient who underwent bilateral nephrectomy and received two lines of treatment. We hypothesized that axitinib, a tyrosine kinase inhibitor, would have a similar plasma concentration to patients without hemodialysis and that the levels before and after hemodiafiltration will not differ significantly, as observed in other targeted therapies. The observed axitinib concentrations were at least an order of magnitude lower than expected based on the literature and measurements in other patients. The present case report indicates a potential risk of axitinib underdosing in patients on hemodiafiltration with the standard dose; therefore, drug dosage may need to be corrected based on the plasma levels of axitinib.

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Citations

Aug 27, 2019·International Journal of Urology : Official Journal of the Japanese Urological Association·Hiroki IshiharaKazunari Tanabe
Apr 3, 2021·Expert Review of Anticancer Therapy·Martina SpisarováHana Študentová

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