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阿贝西利治疗的乳腺癌患者肾功能评估的挑战:一例报告

Challenges of Renal Function Assessment in Breast Cancer Patients Treated With Abemaciclib: A Case Report.

作者信息

Ferreira André, Brito da Silva José, Chuva Maria Teresa, Costa José Maximino, Pereira Deolinda

机构信息

Department of Nephrology, Unidade Local de Saúde Viseu Dão-Lafões, Viseu, PRT.

Department of Nephrology, Instituto Português de Oncologia do Porto Francisco Gentil EPE, Porto, PRT.

出版信息

Cureus. 2024 Aug 25;16(8):e67714. doi: 10.7759/cureus.67714. eCollection 2024 Aug.

Abstract

Abemaciclib, a cyclin-dependent kinase 4/6 (CDK4/6) inhibitor used for hormone-receptor-positive and human epidermal growth factor receptor 2 (HER-2)-negative breast cancer, can lead to elevated serum creatinine without implications on the true renal function. Although clinical trials have shown no increase in other kidney function biomarkers, this may still represent a challenge in cancer patients. We report a case of a 74-year-old female who presented with creatinine and cystatin-C elevation during treatment with abemaciclib without an equivalent decrease in measured glomerular filtration rate (GFR) with renal scintigraphy. The confirmation of adequate kidney function allowed for the maintenance of treatments that would otherwise be limited by renal impairment. Healthcare providers should be aware of abemaciclib's effect on serum creatinine but should not eliminate the possibility of actual kidney injury. Alternative biomarkers for GFR assessment are recommended, although the usefulness of cystatin-C in patients receiving abemaciclib should be investigated in greater depth.

摘要

阿贝西利是一种用于激素受体阳性和人表皮生长因子受体2(HER-2)阴性乳腺癌的细胞周期蛋白依赖性激酶4/6(CDK4/6)抑制剂,可导致血清肌酐升高,但对真正的肾功能并无影响。尽管临床试验表明其他肾功能生物标志物没有增加,但这对癌症患者来说可能仍是一个挑战。我们报告了一例74岁女性病例,该患者在接受阿贝西利治疗期间出现肌酐和胱抑素C升高,而肾脏闪烁扫描显示测量的肾小球滤过率(GFR)并未相应降低。肾功能正常的确认使得原本会因肾功能损害而受限的治疗得以维持。医疗保健提供者应了解阿贝西利对血清肌酐的影响,但不应排除实际肾损伤的可能性。尽管应更深入地研究胱抑素C在接受阿贝西利治疗患者中的效用,但仍建议使用其他GFR评估生物标志物。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/16e9/11420996/87150257c7d6/cureus-0016-00000067714-i01.jpg

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