Renal function in patients receiving streptozocin for locally advanced or metastatic digestive neuroendocrine tumours: results of the Streptotox-FFCD 0906 study - 28/10/21
, Catherine Lombard-Bohas b, Hedia Brixi c, Karine Le Malicot d, Thierry Lecomte e, Laetitia Dahan f, Philippe Ruszniewski g, Abakar Mahamat-Abakar h, Pierre-Luc Etienne i, François-Xavier Caroli-Bosc j, Sophie Dominguez k, Bernard Paule l, Eric Terrebonne m, Pierre Michel n, Côme Lepage o, Gabriel Choukroun pfor Streptotox-FFCD0906 investigators1
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Highlights |
• | This article on STZ-related nephrotoxicity describes one prospective and one retrospective cohort of patients with well-differentiated digestive neuroendocrine tumours. |
• | The efficacy is on line with the previous series. |
• | STZ toxicity was found to be mild when patients were given sufficient hydration before each injection and when doses were adapted in cases of biological renal abnormalities. |
• | Only one grade 3-4 renal toxicity was described among the 111 patients. |
Abstract |
Introduction |
Streptozocin can impair renal function. The purpose of this study was to evaluate the evolution of renal function in patients receiving this anti-mitotic for the treatment of locally advanced/metastatic digestive well differentiated neuroendocrine tumours.
Methods |
A prospective and a retrospective cohort of patients with normal baseline renal function were analysed. The primary endpoint was the incidence of a decrease in the estimated glomerular filtration rate ≥ 25% during treatment. Secondary endpoints were the evaluation of glomerular filtration rate changes, the impact of combined nephrotoxic treatments, other toxicities, compliance, and the objective response rate.
Results |
After screening 142 patients, 27 were included in the prospective and 84 in the retrospective cohort. A decrease in estimated glomerular filtration rate ≥ 25% was observed in 32 patients (30%): respectively four (15.4%) and 28 patients (34.1%) among respectively 26 and 82 patients with numerous measures (P = 0.0097). Altogether, 39 patients (35%) experienced grade 1–2 renal toxicity, while no grade 3−4 occurred in the prospective and 1 occurred in the retrospective cohort. Renal toxicity was more frequent in the retrospective cohort with a less careful follow up. As best responses, objective response was achieved in 27% of patients with pancreatic primary tumours, disease control in 78.9% of patients with pancreatic primary tumours, in 87% of those with small bowel tumours and in 72.7% of patients with other primary locations.
Conclusions |
Strongly recommended for pancreatic NET, streptozocin is associated with frequent mild renal toxicity but low occurrence of renal impairment in patients with baseline normal renal function and under adequate hydration.
Il testo completo di questo articolo è disponibile in PDF.Keywords : Digestive neuroendocrine tumours, Renal function, Streptozocin
Abreviations : NETs, pNETs, STZ, eGFR, PC, RC, MDRD, OR, sbNETs
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Vol 45 - N° 5
Articolo 101572- Settembre 2021 Ritorno al numero
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