Clinical impact of standardized creatinine on dose adjustment of capecitabine

Ayaka Ito, Kazuya Ichikawa, Masayuki Miyazaki, Atsunobu Sagara, Toshiki Motegi, Yuichi Ando, Koji Senzaki, Taku Nagai, Kiyofumi Yamada

Research output: Contribution to journalArticlepeer-review

Abstract

Although the Cockcroft-Gault equation is still used for the dose adjustment of many drugs that have been approved prior to creatinine standardization, the clinical impact of standardized creatinine in the dose adjustment of capecitabine is poorly understood. We focused on patients with borderline renal function and evaluated the tolerability and safety of capecitabine in patients who received capecitabine plus oxaliplatin (Cape-Ox). We retrospectively identified patients with resected colorectal cancer who had received adjuvant therapy with Cape-Ox regimen. Creatinine clearance (CrCL) was calculated by the Cockcroft–Gault equation with standardized creatinine measured using enzymatic methods, and adjusted CrCL was estimated by adding 0.2 (mg/dL) to the serum creatinine in the equation. We defined patients with “pseudo-normal” renal function as those who had an adjusted CrCL of ≤50 mL/min in patients with normal renal function (CrCL >50 mL/min). We evaluated the tolerability and grade 2 or severer adverse events of capecitabine treatment. One hundred four patients had normal and 10 had impaired renal function (CrCL <50 mL/min). Among the 104 patients with normal renal function, 23 (22.1%) had pseudo-normal renal function. Seventeen patients completed the eight cycles of Cape-Ox therapy without treatment delay or dose reduction, and all of them had truly normal renal function. The patients with pseudo-normal renal function were more likely to have grade 2 or severer thrombocytopenia than those with truly normal renal function.

Original languageEnglish
Pages (from-to)547-553
Number of pages7
JournalNagoya journal of medical science
Volume84
Issue number3
DOIs
Publication statusPublished - 2022
Externally publishedYes

All Science Journal Classification (ASJC) codes

  • Medicine(all)

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