Prognostic factors for renal function deterioration during palliative first-line chemotherapy for metastatic colorectal cancer: a retrospective study

Ah Reum Lim, Jwa Hoon Kim, Myung Han Hyun, Yeul Hong Kim, Soohyeon Lee

Research output: Contribution to journalArticlepeer-review

2 Citations (Scopus)

Abstract

Purpose: First-line choice of therapy is critical as it affects treatment decisions in later lines in patients with metastatic colorectal cancer (mCRC). We assessed changes in renal function for 1 year among patients diagnosed with mCRC who received first-line chemotherapy. We aimed to analyze the prognostic factors and effect of each chemotherapy regimen on the renal function of the patients. Methods: We retrospectively investigated patients with mCRC who were treated with a standard triplet regimen (FOLFOX/FOLFIRI with bevacizumab/cetuximab) in the first-line setting at Korea University Anam Hospital from 2015 to 2020. We checked renal function at 3-month intervals for 12 months. We calculated changes in eGFR (△eGFR, estimated glomerular filtration rate) and compared them with clinical factors such as age, sex, chronic disease, body mass index (BMI), disease status, baseline proteinuria, and first-line chemotherapy regimen. Results: Among 472 patients with mCRC, the median eGFR at baseline was 90.9 mL/min/1.73 m2; it was significantly lower (80.1 mL/min/1.73 m2, p < 0.001) at 12 months after chemotherapy initiation. Particularly, the eGFR of patients treated with FOLFIRI + bevacizumab was 74.9 mL/min/1.73 m2. The 1-year incidence rate of acute kidney injury (AKI) was 9.1%, with the lowest occurrence in patients receiving FOLFOX/cetuximab (2.1%) and the highest in those receiving FOLFIRI + bevacizumab (19.2%). Renal dysfunction was more frequent with FOLFIRI + bevacizumab as compared to the other regimens. Additionally, old age, low BMI, and proteinuria at baseline were also associated with a decreased eGFR. Conclusions: These findings can serve as important factors when selecting the first-line chemotherapy regimen for patients with mCRC.

Original languageEnglish
Pages (from-to)8129-8137
Number of pages9
JournalSupportive Care in Cancer
Volume30
Issue number10
DOIs
Publication statusPublished - 2022 Oct
Externally publishedYes

Bibliographical note

Publisher Copyright:
© 2022, The Author(s).

Keywords

  • Acute kidney injury
  • Metastatic colorectal cancer
  • Palliative chemotherapy
  • Renal dysfunction

ASJC Scopus subject areas

  • Oncology

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