Chinese expert consensus on the guidance of anti-tumor drugs for patients with tumor combined chronic kidney disease (2024 edition)

Abstract

The incidence of malignant tumors has steadily increased year by year in China in recent decades. The emergence of innovative anti-cancer drugs has bolstered the prognosis of cancer patients, making it a chronic disease. Kidney injuries are frequent complications of cancer treatment clinically manifested as acute kidney injury (AKI), chronic kidney disease (CKD), proteinuria, and electrolyte disorders, etc. Although kidney injuries affect up to 50% of the patients, there is a lack of professional management guidance for anti-cancer drug dosage adjustment. The clinical pharmacology branch of the Chinese Medical Association has initiated the "Chinese expert consensus on the guidance of anti-tumor drugs for patients with tumor combined chronic kidney disease (2024 edition)". We unified national multidisciplinary experts to analyze clinical evidence with the Delphi method, and conducted expert interviews and seminars focusing on kidney function assessment, anti-tumor drug dosage adjustment for kidney disease patients. We make recommendations on selection and dose adjustment of anti-tumor drugs (chemotherapy, small molecules and antibodies) according to chemotherapeutic drug classifications, providing practical and feasible scientific guidance for clinicians.