Chronic kidney disease affects about a third of all people diagnosed with cancer and leads to worse cancer outcomes. The UHN Onco-Nephrology Program provides care to patients who have kidney complications due to cancer or cancer therapies.
A study led by Dr. Abhijat Kitchlu at the Toronto General Hospital Research Institute suggests that too many cancer patients with chronic kidney disease are being excluded from clinical trials. As part of the study, the team examined results from clinical trials for the five most common solid cancers. Their findings revealed that 85% of the trials excluded patients with chronic kidney disease by using inappropriate criteria. Specifically, these trials excluded patients based on the results of a blood test for creatinine without adjustment for age, sex, race or body size—an approach that is not useful for measuring kidney function in cancer patients. Explains Dr. Kitchlu, “Currently, cancer patients with chronic kidney disease have very limited treatment options. Broadening the eligibility criteria in cancer trials by using more accurate measures of kidney function would enable more of these patients to benefit from novel cancer therapies.”
Our onco-nephrology research program has two aims: 1) to prevent and manage kidney complications in patients with cancer (including both cancer-induced and cancer therapy-related causes of kidney injury); and 2) to improve cancer care in patients with chronic kidney disease. In order to address these aims, Dr. Abhijat Kitchlu’s clinical research has involved using a combination of ‘big data’ (i.e. population-level healthcare administrative data) in conjunction with highly granular local registry datasets.