An elevated serum creatinine in a patient receiving palbociclib

Abstract

Background:

Serum Creatinine (SCr) is the most widely used parameter in clinical practice to estimate glomerular filtration rate (GFR). Various drugs have been reported to cause a reversible and transient elevation in SCr without a true reduction in overall kidney function

Case Presentation:

We describe a case of a 66-year-old-woman with right breast poorly differentiated invasive ductal carcinoma, hormone receptor positive and HER2 negative who received treatment with fulvestrant and palbociclib. The initial dose of Palbociclib was 125 mg orally a day, then reduce to 100 mg orally a day. She presented for evaluation of elevated serum creatinine with decreased eGFR. Upon evaluation an estimated glomerular filtration rate by cystatin C showed kidney function at her baseline for the past year.

Conclusion:

Palbocicib is a selective inhibitor of the cyclin-dependent kinases CDK4 and CDK6. Physicians should be aware that patients undergoing therapy with palbociclib require monitoring of kidney function and an increase in serum creatinine from baseline, might represent an inhibitory effect of the secretion of creatinine.

Keywords

Palbociclib CDK4 6 inhibitor AKI cystatin C onconephrology

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References

Samra

Abcar

AC.

False estimates of elevated creatinine. Perm J 2012; 16(2): 51.

Chappell

Turner

Pak

, et al. Abemaciclib inhibits renal tubular secretion without changing glomerular filtration rate. Clin Pharmacol Ther 2019; 105(5): 1187–1195.

Gao

Cheng

Bloomquist

, et al. CDK4/6 inhibitor treatment for patients with hormone receptor-positive, HER2-negative, advanced or metastatic breast cancer: a US Food and Drug Administration pooled analysis. Lancet Oncol 2020; 21(2): 250–260.

Patnaik

Rosen

Tolaney

, et al. Efficacy and safety of abemaciclib, an inhibitor of CDK4 and CDK6, for patients with breast cancer, non–small cell lung cancer, and other solid tumors. Cancer Discov 2016; 6(7): 740–753.

Ciarimboli

Lancaster

Schlatter

, et al. Proximal tubular secretion of creatinine by organic cation transporter OCT2 in cancer patients. Clin Cancer Res 2012; 18(4): 1101–1108.

Goetz

Toi

Campone

, et al. MONARCH 3: abemaciclib as initial therapy for advanced breast cancer. J Clin Oncol 2017; 35: 3638–3646.

Dickler

Tolaney

Rugo

, et al. MONARCH 1, a phase II study of abemaciclib, a CDK4 and CDK6 inhibitor, as a single agent, in patients with refractory HR+/HER2− metastatic breast cancer. Clin Cancer Res 2017; 23(17): 5218–5224.