Decreased kidney function may be a side effect of anti-cancer drug crizotinib.

This trial assessed whether the anti-cancer drug crizotinib (Xalkori) leads to decreased kidney function as a side effect. The trial concluded that while taking crizotinib kidney function is decreased; however, function recovers once drug administration is stopped. 

Several non-small cell lung ancers (NSCLCs) are driven by the joining of the anaplastic lymphoma kinase (ALK) gene with another gene. Crizotinib is a drug used to treat ALK-positive NSCLCs. Crizotinib has been shown to lead to longer progression free survival (time from treatment until disease progression) than chemotherapy. Several known side effects of the drug are gastrointestinal disturbances, fatigue and visual disturbances. The effect of crizotinib on kidney function has not been studied yet. 

This trial looked at the effect of crizotinib on kidney function during and after treatment. This study reviewed the records of 38 patients with stage 4 (spread beyond the lungs) ALK-positive NSCLC. All patients were treated with crizotinib. The estimated glomerular filtration rate (eGFR, a test that measures kidney function) was measured before treatment (baseline), during the first 12 weeks of treatment and at the end of treatment.

Overall, there was an average decrease of 23.9% in eGFR during the first 12 weeks of treatment, with the steepest decrease (19.9%) in the first 2 weeks of therapy. The decrease in eGFR was not due to dehydration, other drugs or tumor shrinkage.

Following therapy, all patients recovered eGFR above or equal to 84% of their baseline. 

This study concluded that crizotinib was associated with decreased kidney function during treatment, but that kidney function recovered once treatment was stopped. 

Patients were treated with crizotinib for an average of 16 months however only the first 3 months was examined. The patient sample was also very small.

Patients on crizotinib long term should have their renal function routinely monitored.