LIPOSOMAL CISPLATIN IN CANCER PATIENTS WITH RENAL FAILURE

One of the serious adverse reactions with the administration of chemotherapeutical agents is renal failure. In general, when the level of creatinine/glomerular filtration data is high, chemotherapy involving almost all cytotoxic agents is avoided or the dosage is reduced. Liposomal cisplatin (lipoplatin) is a new agent which has been tested in Phase I, II and III trials and norenal toxicity has been reported. In the present trial, this agent was tested as monotherapy and in combination with gemcitabine or paclitaxel or 5-fluorouracil-leucovorin, mainly in lung and bladder cancer patients with renal insufficiency. Forty-two patients, (14 with non-small-cell lung cancer, 2 with squamous cell carcinoma non-small-cell lung cancer, 16 with bladder cancer and 10 gastrointestinal tract cancer), were included. There were 40 men and 2 women, median age 65 y (range 49-84). Lipoplatin and gemcitabine were administered to patients with bladder cancer, the first day, repeated every 2 weeks; paclitaxel, plus lipoplatin as above, were administered to lung cancer patients; patients with gastrointestinal tract cancer received 5-fluorouracil and leucovorin, plus lipoplatin as above. The median number of courses was 6 (range 2-12). Serum creatinine was 1.6 mg/dl to 4.0 mg/dl (median 2.4 mg/dl). No serum creatinine increase was observed in any of the patients. Grade 1-2 myelotoxicity and anemia were observed in 28.57% and 50% of the patients, respectively. Liposomal cisplatin is a new agent, which according to the literature and the present study, is an eligible cytotoxic agent for patients with renal insufficiency.