Abstract
CPT-11 belongs to the class of topoisomeraseⅠ inhibitors and is a prodrug of SN-38. It is extensively metabolized in the liver and is partially excreted by the kidney. Therefore, for patients with renal insufficiency, CPT-11 dose modification is not required. In addition, the relationship between renal function and CPT-11 adverse events has not been explored. However, a recent study showed that the elimination of SN-38 was significantly delayed in patients with severe renal failure compared to that in patients with normal renal function. To demonstrate the relationship between adverse events (hematotoxicity) of CPT-11 and renal function, we retrospectively investigated 40 lung cancer patients who first received combination therapy of irinotecan and carboplatin at the Hokkaido Keiaikai Sapporo Minami-sanjo Hospital. The subjects of the survey had nadir levels of renal function and blood count from the first cycle to the next. Correlation was observed between: 1) Renal function parameters and white blood cell count, 2) renal function parameters and neutrophil count, 3) renal function parameters and hemoglobin level. Furthermore, significant negative correlations were observed between renal function parameters and age. These correlations indicate that hematologic toxicities were not directly related to renal function, but were dependent on age, and suggest that age-related functional decline of the organ might have influence on hematologic toxicities.
