Abstract 3263
Background
Risk factors of cisplatin induced acute kidney injury (AKI) patients has been well described. In HNSCC, an incidence of cisplatin induced AKI was observed in 34.2%. Most studies reported AKI as a surrogate endpoint. However, delayed cisplatin induced nephrotoxicity and long-term renal outcomes were not well studied.
Methods
Locally advanced HNSCC patients treated between 1/2007 and 12/2018 who underwent definitive or post-operative chemoradiotherapy (CRT) with cisplatin were identified. Patient characteristics, treatments, creatinine at baseline, during, 3, 6, and 12 months after CRT completion were retrospectively reviewed. Acute kidney disease (AKD) was defined by (i) estimated glomerular filtration rate (eGFR) <60 ml/min/ 1.73 m2 for <3 months, or (ii) decrease in eGFR by ≥ 35 %, or (iii) increase in serum creatinine by > 50 % for <3 months.
Results
A total of 509 patients were analyzed. Overall AKD occurred in 27.9% patients. Most patients (95%) had prophylactic feeding. ECOG of 0 was more prominent in AKD patients (p = 0.017) and hypertension (p < 0.001). Most patients received definitive CRT (83%) with mean cumulative dose of cisplatin during CRT and entire treatment of 189 mg/m2, and 400 mg/m2, respectively. There was no statistical difference in cumulative dose, delay, dose reduction, termination, and hospitalization. In AKD patients, eGFR started to decline significantly during CRT (-36%) and worsened at 3 months (-39%) after CRT. The eGFR started to improve at 12 months after CRT (-29%), but did not recover to baseline nor non-AKD patients. In multivariate analysis, ECOG of 0 (OR = 1.77), and hypertension (OR = 2.25) were a significant predictive factor for AKD.
Conclusions
Almost one third of locally advanced HNSCC patients who underwent CRT with cisplatin developed AKD with peak incidence at 3 months after CRT. After 1 year, eGFR of patients with AKD had not recovered, and remained at -30% below baseline. ECOG 0 and hypertension were a predictor for AKD. Hypertension might reflect underlying kidney disease which leads to susceptibility to kidney injury. Moreover, physician’s awareness of AKD and underestimation of potential complications in fit patients might explain these findings.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.
Resources from the same session
5056 - Phase 2 study of 2 dosing regimens of cemiplimab, a human monoclonal anti–PD-1, in metastatic cutaneous squamous cell carcinoma (mCSCC)
Presenter: Danny Rischin
Session: Poster Display session 3
Resources:
Abstract
5710 - Avelumab for advanced Merkel cell carcinoma in the Netherlands; a nationwide survey
Presenter: Sonja Levy
Session: Poster Display session 3
Resources:
Abstract
3152 - Health-related quality of life in patients with metastatic Merkel cell carcinoma receiving second-line or later avelumab treatment: 36-month follow-up data
Presenter: Sandra D'Angelo
Session: Poster Display session 3
Resources:
Abstract
5715 - A Phase 2, Randomized Study of Nivolumab (NIVO) and Ipilimumab (IPI) versus NIVO, IPI and Stereotactic Body Radiation Therapy (SBRT) for Metastatic Merkel Cell Carcinoma (MCC, NCT03071406) – a preliminary report.
Presenter: Sungjune Kim
Session: Poster Display session 3
Resources:
Abstract
2854 - Real-world impact of immune checkpoint inhibitors in metastatic uveal melanoma
Presenter: Kalijn Bol
Session: Poster Display session 3
Resources:
Abstract
2928 - Immune checkpoint inhibitors in a cohort of 206 metastatic uveal melanomas patients
Presenter: Mathilde Saint-Ghislain
Session: Poster Display session 3
Resources:
Abstract
1235 - Incidence and survival of Uveal Melanoma occurring as single cancer versus its occurrence as a first or second primary neoplasm
Presenter: Ahmad Alfaar
Session: Poster Display session 3
Resources:
Abstract
3615 - Validation of a Clinicopathological and Gene Expression Profile (CP-GEP) Model for Sentinel Lymph Node Metastasis in Primary Cutaneous Melanoma
Presenter: Evalyn Mulder
Session: Poster Display session 3
Resources:
Abstract
1793 - External validation of the 8th Edition Melanoma Staging System of the American Joint Committee on Cancer (AJCC) using the Surveillance, Epidemiology and End Results (SEER) Program
Presenter: Angelina Tjokrowidjaja
Session: Poster Display session 3
Resources:
Abstract
4278 - Clinical factors and overall survival (OS) associated with patterns of metastases (mets) in melanoma patients (pts).
Presenter: Ines Pires da Silva
Session: Poster Display session 3
Resources:
Abstract