Nephrotoxicity of Chemotherapy Drugs

Cisplatin Tolerance Test

Cisplatin is one of the most effective chemotherapeutic agents available, yet it has serious side effects including damage to the kidney (nephrotoxicity) in a subset of patients. Cisplatin is routinely used in the treatment of cancers of the lung, breast, ovaries, bladder, head and neck, and testes. Because of its known nephrotoxic activity, patients treated with cisplatin have routine assessment of their kidney function before starting a cisplatin-based treatment and during the course of their chemotherapy. Most commonly, serum creatinine (SCr) is used directly or to estimate the kidney’s glomerular filtration rate (eGFR) to assess a patient’s renal fitness to a treatment with cisplatin. For example, in patients with an eGFR below 60 mL/min treatment with cisplatin is not recommended. However, in patients receiving cisplatin, there is currently no test that can assess the risk of having a serious kidney adverse event if treated with cisplatin. Serum creatinine and novel markers of acute kidney injury (AKI) provide the clinician with an answer only after administration of each cisplatin dose when damage has already occurred. Metabolon is developing a Cisplatin Tolerance Test that measures the risk of AKI with cisplatin treatment based on a metabolic signature in the patients’ blood or urine from the time of the patient work-up and throughout the course of chemotherapy. By identifying patients at risk of serious kidney damage from cisplatin, clinicians can select the most appropriate treatment options to balance treatment efficacy with patient safety.