From the Guidelines
Severe renal failure is a potential risk associated with certain cancer treatments, but it is not a commonly reported side effect of docetaxel or Phesgo, according to the most recent evidence available 1. When considering the potential for severe renal failure, it's essential to understand the mechanisms of nephrotoxicity associated with oncologic treatments.
- Cytotoxic chemotherapeutic drugs, such as platinum-containing compounds, ifosfamide, and gemcitabine, are known to cause kidney injury, including acute tubular injury (ATI) and thrombotic microangiopathy (TMA) 1.
- Targeted cancer drugs, including anti-angiogenesis drugs, can also cause adverse renal effects, such as hypertension, proteinuria, and lesions like TMA and minimal change disease 1. However, docetaxel and Phesgo are not explicitly mentioned in the study as common causes of severe renal failure.
- Docetaxel, a chemotherapy drug, can cause kidney damage, particularly at high doses or in patients with pre-existing kidney issues, but this is not typically characterized as severe renal failure 1.
- Phesgo, a combination of pertuzumab, trastuzumab, and hyaluronidase, has less direct nephrotoxicity, but may occasionally impact kidney function, although severe renal failure is not a commonly reported side effect 1. Regular monitoring of kidney function through blood tests and adequate hydration is crucial for patients receiving these medications to minimize the risk of kidney problems 1.
From the Research
Severe Renal Failure and Docetaxel or Phesgo
- There is limited direct evidence on the specific relationship between docetaxel or Phesgo and severe renal failure.
- However, studies have investigated the renal safety profile of anticancer agents targeting HER2, such as trastuzumab and pertuzumab, which are often used in combination with docetaxel 2, 3.
- A case report described the use of pertuzumab in a patient receiving hemodialysis, demonstrating its relatively safe and effective use in a patient with end-stage renal disease 2.
- Another study discussed the renal safety profile of agents targeting HER2 or EGFR, noting that renal toxicity is not common but may occur when these agents are combined with traditional chemotherapeutic agents 3.
- There is also evidence on the safety and efficacy of trastuzumab emtansine (TDM-1) in a patient on hemodialysis for renal failure, which may be relevant to the use of other HER2-targeting agents in patients with renal impairment 4.
- General guidelines for dose adjustments of anticancer drugs in patients with renal or hepatic impairment have been published, which may be applicable to docetaxel and Phesgo 5.
- Additionally, considerations for drug dosing in critically ill patients receiving continuous renal replacement therapy have been discussed, highlighting the importance of optimizing drug administration strategies in patients with renal impairment 6.