Old age, metastatic cancer predict cisplatin-induced nephrotoxicity

Age >65 years and metastatic cancer are significantly associated with cisplatin-induced nephrotoxicities, a recent study has found. An association also exists between cumulative dose and nephrotoxicity or digestive toxicity.

“Cisplatin is a cytotoxic drug that triggers several toxicities,” the authors said. “However, nephrotoxicity and ototoxicity remain major clinical limitations.”

A prospective descriptive study was carried out for 4 months to examine the incidence of chemotherapy toxicity induced by cisplatin and to analyse the influence of risk factors in the Tunisian population. Patients with pathologically confirmed malignancies and treated with cisplatin-regimen chemotherapy were included in the analysis.

The authors graded nephrotoxicity and digestive toxicity based on the World Health Organization toxicity scale and scored ototoxicity in accordance with the Common Terminology Criteria for Adverse Events. They also performed a multivariate logistic regression analysis to assess the influence of clinical variables on cisplatin-induced toxicity.

Of the 150 patients included, 44 percent developed cisplatin-regimen toxicity (15 percent cisplatin-induced nephrotoxicity, 9 percent cisplatin-induced ototoxicity, and 27 percent digestive toxicity). Multivariate analysis revealed that age >65 years (odds ratio [OR], 6.129; p=0.010), metastatic cancer (OR, 0.171; p=0.007), and cumulative dose (OR, 1.004 mg/m²; p=0.042) were strong risk factors for cisplatin-induced nephrotoxicity.

In addition, the cumulative dose was independently prognostic of digestive toxicity (OR, 0.997; p=0.002).