D. Ross Camidge, MD, PhD, Evelyn M

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Crizotinib Effects on Creatinine and Non-Creatinine–Based Measures of Glomerular Filtration Rate D. Ross Camidge, MD, PhD, Evelyn M. Brosnan, MD, Chamath DeSilva, MD, Phillip J. Koo, MD, Michel Chonchol, MD Journal of Thoracic Oncology Volume 9, Issue 11, Pages 1634-1637 (November 2014) DOI: 10.1097/JTO.0000000000000321 Copyright © 2014 International Association for the Study of Lung Cancer Terms and Conditions

FIGURE 1 Changes in serum creatinine and carcinoembryonic antigen (CEA) levels on commencement and cessation of crizotinib treatment in a patient with pre-existing renal impairment. Units of CEA (ng/ml) and creatinine (mg/dl) are shown on the y axis and dates of measurements on the x axis. The green and blue horizontal lines represent the lower and upper limits of normal of each assay, respectively. Of note, CEA is known to be renally excreted, and the patient had a complete metabolic and radiographic response on positron emission tomography/computed tomography scanning that occurred rapidly and persisted during this period of time, despite the changes in CEA. Journal of Thoracic Oncology 2014 9, 1634-1637DOI: (10.1097/JTO.0000000000000321) Copyright © 2014 International Association for the Study of Lung Cancer Terms and Conditions

FIGURE 2 Changes in creatinine-based estimates of the glomerular filtration rate (GFR) using the Chronic Kidney Disease Epidemiology Collaboration equation (estimated GFR [eGFR]) and in non-creatinine–based measurements of the GFR using iothalamate assessments (measured GFR [mGFR]). A, In the patient with pre-existing renal impairment shown in Figure 1, assessments were made while on crizotinib and then after holding crizotinib for 23 days, showing a minor improvement in the eGFR and a large improvement in the mGFR, consistent with some direct effect of crizotinib on true renal function, as supported by the changes in CEA independent of changes in radiographic tumor activity (see text). B, In a patient holding crizotinib for 9 days and then restarting the drug, although there was a reduction in the eGFR on restarting, the mGFR actually increased, suggesting that some acute effect of crizotinib on creatinine secretion could also be occurring. Journal of Thoracic Oncology 2014 9, 1634-1637DOI: (10.1097/JTO.0000000000000321) Copyright © 2014 International Association for the Study of Lung Cancer Terms and Conditions