How would you treat metastatic colon cancer in patients on dialysis?

Topics: Gastrointestinal Cancers • Medical Oncology

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...

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