2023 Targeted Therapies of Lung Cancer Meeting (Poster)-P1.03. Lung Cancer Approved Tyrosine Kinase Inhibitors That Inhibit MATE-1 can Lead to “False” Decreases in Renal Function

P1.03. Lung Cancer Approved Tyrosine Kinase Inhibitors That Inhibit MATE-1 can Lead to “False” Decreases in Renal Function

Back to course

Pdf Summary

Tyrosine kinase inhibitors (TKIs) used in the treatment of lung cancer can inhibit the function of multidrug and toxin extrusion transporters (MATE) in renal proximal tubule cells, leading to false decreases in renal function when measured by creatinine clearance. Cystatin C is being investigated as an alternative marker for renal function in patients on TKIs, as it is not affected by transporter inhibitors. <br /><br />A study conducted at Memorial Sloan Kettering Cancer Center analyzed data from patients with non-small cell lung cancer who received treatment with TKIs known to inhibit MATE (brigatinib, capmatinib, crizotinib, entrectinib, lorlatinib, pralsetinib, selpercatinib, tepotinib) from 2014 to 2022. The study used KDIGO criteria to assess renal function, with stage 1 defined as 1.5x to 2x baseline creatinine, stage 2 as 2x to 3x baseline creatinine, and stage 3 as 3x baseline creatinine. Cystatin C data was analyzed whenever available. <br /><br />The results showed that in 96% of cases (49 out of 51), cystatin C measurements corresponded to improved renal function compared to creatinine-based measurements. Three patients who received selpercatinib had serial measurements of both creatinine and cystatin C over several years, and in all cases, cystatin C indicated improved renal function. Additionally, when comparing serial renal function estimates from cystatin C and creatinine, cystatin C consistently showed a better trajectory of renal function improvement.<br /><br />The study concludes that patients on TKIs can be falsely interpreted as having kidney injury based on creatinine measurements, which may lead to unnecessary holds and dose reductions of critical cancer therapy. Cystatin C, on the other hand, appears to be a better estimator of kidney function in patients on TKIs and may provide a more accurate assessment of renal health. Further research is needed to validate these findings and explore the clinical implications of using cystatin C as an alternative marker for renal function in patients on TKIs.

Asset Subtitle

Monica Chen, MSKCC, United States

Meta Tag

Speaker Monica Chen, MSKCC, United States

Topic Poster Listing

Keywords

Tyrosine kinase inhibitors

lung cancer treatment

MATE inhibitors

renal function

creatinine clearance

Cystatin C

renal health

kidney injury

cancer therapy

clinical implications