How would you treat metastatic colon cancer in patients on dialysis?
What would you consider in the first and second line settings with intact MMR/MSI?
Answer from: Medical Oncologist at Academic Institution
Fortunately, our standard regimen of 5FU and oxaliplatin are quite safe to administer for patients with chronic renal insufficiency/on dialysis:
- 5FU is cleared through non-renal mechanisms and does not require any dose adjustments
- BUT...exposure to capecitabine is higher in patients with renal...
Comments
Medical Oncologist at Hematology Oncology Associates of the Palm Beaches Do you give the oxaliplatin before or after dialys...
Medical Oncologist at Facultad de Medicina Universidad Autonoma de San Luis Potosi Dr Garcia , oxaliplatin has a high dializability ...
Answer from: Medical Oncologist at Academic Institution
I generally agree with Dr Pishvaian. I would like to emphasize that capecitabine is completely contraindicated. Dose should be reduced for GFR < 30 ml/min but this is not safe for dialysis patients and cannot be given on a continuous basis.
Neither FU or platinums need any dose adjus...
Do you give the oxaliplatin before or after dialys...
Dr Garcia , oxaliplatin has a high dializability ...