Tags

Type your tag names separated by a space and hit enter

A randomized trial comparing the nephrotoxicity of cisplatin/ifosfamide-based combination chemotherapy with or without amifostine in patients with solid tumors.
Invest New Drugs 2000; 18(3):281-9IN

Abstract

This study evaluates the degree of kidney damage during cisplatin/ifosfamide-based combination chemotherapy and its possible prevention by amifostine. Thirty-one patients with solid tumors stratified according to pretreatment were randomized to receive VIP- or TIP-chemotherapy with or without amifostine (910 mg/m2) given as a short infusion prior to cisplatin. Chemotherapy consisted of cisplatin (50 mg/m2), ifosfamide (4 g/m2) and either etoposide (500 mg/m2) (= VIP) or paclitaxel (175 mg/m2) (= TIP) repeated at 3 weekly intervals. For all patients the glomerular filtration rate (GFR) measured by creatinine-clearance, serum creatinine, electrolytes and differential urinary protein/enzyme excretion were determined prior to, during and after each cycle. A total of 62 cycles of chemotherapy were evaluable. In the amifostine-group GFR was fully maintained after application of two cycles of chemotherapy, whereas in the control group a > 30%-reduction of median GFR (108 to 80 ml/min) was observed (p < 0.001). Patients receiving amifostine had a lower degree of high molecular weight proteins excretion indicating less glomerular damage. In both groups significant increases of tubular marker profiles peaking at day 3 after chemotherapy were observed with a nearly complete reversibility of these changes prior to the next chemotherapy cycle. The number of patients with low magnesium serum levels during treatment was 17% after amifostine application versus 69% in control patients. The results seem to indicate that treatment with amifostine can preserve GFR after application of two cisplatin/ifosfamide-based chemotherapy cycles. This may be advantageous if repetitive cycles of chemotherapy or subsequent administration of high dose chemotherapy is planned.

Authors+Show Affiliations

Department of Hematology and Oncology, UKT-Medical Center II, Eberhard-Karls-University of Tübingen, Germany. joerg.hartmann@med.uni-tuebingen.deNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Comparative Study
Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

10958599

Citation

Hartmann, J T., et al. "A Randomized Trial Comparing the Nephrotoxicity of Cisplatin/ifosfamide-based Combination Chemotherapy With or Without Amifostine in Patients With Solid Tumors." Investigational New Drugs, vol. 18, no. 3, 2000, pp. 281-9.
Hartmann JT, Fels LM, Knop S, et al. A randomized trial comparing the nephrotoxicity of cisplatin/ifosfamide-based combination chemotherapy with or without amifostine in patients with solid tumors. Invest New Drugs. 2000;18(3):281-9.
Hartmann, J. T., Fels, L. M., Knop, S., Stolt, H., Kanz, L., & Bokemeyer, C. (2000). A randomized trial comparing the nephrotoxicity of cisplatin/ifosfamide-based combination chemotherapy with or without amifostine in patients with solid tumors. Investigational New Drugs, 18(3), pp. 281-9.
Hartmann JT, et al. A Randomized Trial Comparing the Nephrotoxicity of Cisplatin/ifosfamide-based Combination Chemotherapy With or Without Amifostine in Patients With Solid Tumors. Invest New Drugs. 2000;18(3):281-9. PubMed PMID: 10958599.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A randomized trial comparing the nephrotoxicity of cisplatin/ifosfamide-based combination chemotherapy with or without amifostine in patients with solid tumors. AU - Hartmann,J T, AU - Fels,L M, AU - Knop,S, AU - Stolt,H, AU - Kanz,L, AU - Bokemeyer,C, PY - 2000/8/25/pubmed PY - 2001/2/28/medline PY - 2000/8/25/entrez SP - 281 EP - 9 JF - Investigational new drugs JO - Invest New Drugs VL - 18 IS - 3 N2 - This study evaluates the degree of kidney damage during cisplatin/ifosfamide-based combination chemotherapy and its possible prevention by amifostine. Thirty-one patients with solid tumors stratified according to pretreatment were randomized to receive VIP- or TIP-chemotherapy with or without amifostine (910 mg/m2) given as a short infusion prior to cisplatin. Chemotherapy consisted of cisplatin (50 mg/m2), ifosfamide (4 g/m2) and either etoposide (500 mg/m2) (= VIP) or paclitaxel (175 mg/m2) (= TIP) repeated at 3 weekly intervals. For all patients the glomerular filtration rate (GFR) measured by creatinine-clearance, serum creatinine, electrolytes and differential urinary protein/enzyme excretion were determined prior to, during and after each cycle. A total of 62 cycles of chemotherapy were evaluable. In the amifostine-group GFR was fully maintained after application of two cycles of chemotherapy, whereas in the control group a > 30%-reduction of median GFR (108 to 80 ml/min) was observed (p < 0.001). Patients receiving amifostine had a lower degree of high molecular weight proteins excretion indicating less glomerular damage. In both groups significant increases of tubular marker profiles peaking at day 3 after chemotherapy were observed with a nearly complete reversibility of these changes prior to the next chemotherapy cycle. The number of patients with low magnesium serum levels during treatment was 17% after amifostine application versus 69% in control patients. The results seem to indicate that treatment with amifostine can preserve GFR after application of two cisplatin/ifosfamide-based chemotherapy cycles. This may be advantageous if repetitive cycles of chemotherapy or subsequent administration of high dose chemotherapy is planned. SN - 0167-6997 UR - https://www.unboundmedicine.com/medline/citation/10958599/A_randomized_trial_comparing_the_nephrotoxicity_of_cisplatin/ifosfamide_based_combination_chemotherapy_with_or_without_amifostine_in_patients_with_solid_tumors_ L2 - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&amp;PAGE=linkout&amp;SEARCH=10958599.ui DB - PRIME DP - Unbound Medicine ER -