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Individualized treatment of breast cancer with chronic renal failure: A case report and review of literature

World Journal of Clinical Cases 2021年第33期9卷 10345-10354页

作者： Jie-Hui Cai Jie-Hua Zheng Xiao-Qi Lin Wei-Xun Lin Juan Zou Yao-Kun Chen Zhi-Yang Li Ye-Xi Chen Department of General Surgery The Second Affiliated Hospital of Shantou University Medical CollegeShantou 515041Guangdong ProvinceChina Breast Disease Research Center The Medical Research Institute of Shantou Doctoral AssociationShantou 515041Guangdong ProvinceChina

BACKGROUND Studies have shown that patients with chronic renal failure(CRF)are more likely to suffer from breast cancer and other malignant *** our knowledge,CRF can reduce drug excretion,thereby increase drug exposure and lead to increased toxicity,which will limit drug treatment and lead to tumor ***,there are few successful reports on the combination of docetaxel,trastuzumab,and pertuzumab(THP)as a neoadjuvant treatment regimen for breast cancer patients with *** SUMMARY We report a breast cancer(cT2N2M0,Her-2+/HR-)patient with *** was a clinical stage IIIA tumor on the left *** patient had suffered from uremia for 2 years,and her heart function was *** on the pathological type,molecular type,and clinical stage of breast cancer,and the patient’s renal function,the clinician analyzed the pharmacological and pharmacokinetic characteristics of the antitumor drugs after consulting the relevant literature,and prescribed the neoadjuvant regimen of THP(docetaxel 80 mg/m²,trastuzumab 8 mg/kg for the first dose,and 6 mg/kg for the maintenance dose with pertuzumab 840 mg for the first dose and 420 mg for the maintenance dose),once every 3 wk,for a total of 6 *** neoadjuvant treatment had a good effect,and the patient then underwent surgery which was *** CRF is not a contraindication for systemic treatment and surgery of breast *** THP regimen without dose adjustment may be a safe and effective neoadjuvant treatment for HER-2 positive breast cancer patients with CRF.

关键词： Breast cancer Chronic renal failure Neoadjuvant treatment dose adjustment Pertuzumab Case report

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Pharmacokinetic and pharmacodynamic considerations of antimicrobial drug therapy in cancer patients with kidney dysfunction

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World Journal of Nephrology 2015年第3期4卷 330-344页

作者： Frieder Keller Bernd Schrppel Ulla Ludwig Section of Nephrology Department of Internal Medicine 1University Hospital

Patients with cancer have a high inherent risk of infectious *** addition,the incidence of acute and chronic kidney dysfunction rises in this *** drugs often require dosing modifications based on an estimate of kidney function,usually the glomerular filtration rate(GFR).However,there is still no preferential GFR formula to be used,and in acute kidney injury there is always a considerable time delay between true kidney function and estimated *** most cases,the anti-infective therapy should start with an immediate and high loading *** as well as pharmacodynamic principles must be applied for further dose ***-infective drugs with time-dependent action should be given with the target of high trough concentrations(e.g.,beta lactam antibiotics,penems,vancomycin,antiviral drugs).Anti-infective drugs with concentration-dependent action should be given with the target of high peak concentrations(e.g.,aminoglycosides,daptomycin,colistin,quinolones).Our group created a pharmacokinetic database,called NEPharm,hat serves as a reference to obtain reliable dosing regimens of anti-infective drugs in kidney dysfunction as well as renal replacement *** avoid the risk of either too low or too infrequent peak concentrations,we prefer the eliminated fraction rule for dose adjustment calculations.

关键词： Anti-infective drugsl Cancer Kidney function Pharmacodynamics Pharmacokinetics dose adjustment NEPharm

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