title: Management of anticancer treatment in patients under chronic dialysis: results of the multicentric CANDY (CANcer and DialYsis) study.
abstract: BACKGROUND
  One million people worldwide benefit from chronic dialysis, with an increased rate in Western countries of 5% yearly. Owing to increased incidence of cancer in dialyzed patients, the management of these patients is challenging for oncologists/nephrologists.
  
  
  METHODS
  The CANcer and DialYsis (CANDY) retrospective multicenter study included patients under chronic dialysis who subsequently had a cancer (T0). Patients were followed up for 2 years after T0. Prescriptions of anticancer drugs were studied with regard to their renal dosage adjustment/dialysability.
  
  
  RESULTS
  A total of 178 patients from 12 institutions were included. The mean time between initiation of dialysis and T0 was 30.8 months. Fifty patients had received anticancer drug treatment. Among them, 72% and 82% received at least one drug needing dosage and one drug to be administered after dialysis sessions, respectively. Chemotherapy was omitted or prematurely stopped in many cases where systemic treatment was indicated or was often not adequately prescribed.
  
  
  CONCLUSIONS
  Survival in dialysis patients with incident cancer was poor. It is crucial to consider anticancer drug treatment in these patients as for non-dialysis patients and to use current available specific drug management recommendations in order to (i) adjust the dose and (ii) avoid premature elimination of the drug during dialysis sessions.
authors.affiliation: Service ICAR-Department of Nephrology, Pitié-Salpêtrière Hospital, Paris. Electronic address: nicolas.janus@psl.aphp.fr.
authors.forename: N
authors.initials: N
authors.lastname: Janus
authors.affiliation: Service ICAR-Department of Nephrology, Pitié-Salpêtrière Hospital, Paris.
authors.forename: V
authors.initials: V
authors.lastname: Launay-Vacher
authors.affiliation: Department of Oncology, Antoine Lacassagne Center, University of Nice Sophia-Antipolis, Nice.
authors.forename: A
authors.initials: A
authors.lastname: Thyss
authors.affiliation: Department of Nephrology and Dialysis, Clinique de l'Estrée, Stains.
authors.forename: H
authors.initials: H
authors.lastname: Boulanger
authors.affiliation: Department of Nephrology, Pasteur Hospital, Nice.
authors.forename: O
authors.initials: O
authors.lastname: Moranne
authors.affiliation: Department of Nephrology, Pasteur Hospital, Nice.
authors.forename: M S
authors.initials: MS
authors.lastname: Islam
authors.affiliation: Department of Nephrology, Hemodialysis center of Orgemont, Angers.
authors.forename: J-P
authors.initials: JP
authors.lastname: Durande
authors.affiliation: Department of Nephrology, Annecy Hospital, Annecy.
authors.forename: M
authors.initials: M
authors.lastname: Ducret
authors.affiliation: Department of Nephrology, Edouard Herriot Hospital, Lyon.
authors.forename: L
authors.initials: L
authors.lastname: Juillard
authors.affiliation: Department of Nephrology, Bocage Hospital, Dijon.
authors.forename: Z
authors.initials: Z
authors.lastname: Soltani
authors.affiliation: Department of Nephrology, Bocage Hospital, Dijon.
authors.forename: G
authors.initials: G
authors.lastname: Motte
authors.affiliation: Department of Nephrology, Suzanne Levy Hemodialysis center, Mont Louis Clinic, Paris.
authors.forename: J
authors.initials: J
authors.lastname: Rottembourg
authors.affiliation: Department of Nephrology, Pitié-Salpêtrière Hospital, Paris, France.
authors.forename: G
authors.initials: G
authors.lastname: Deray
authors.affiliation: Department of Oncology, Antoine Lacassagne Center, University of Nice Sophia-Antipolis, Nice.
authors.forename: J
authors.initials: J
authors.lastname: Thariat
mesh_terms: D000368:Aged; D000740:Anemia / Q000150:complications / Q000188:drug therapy; D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000097:blood / Q000627:therapeutic use*; D019468:Disease Management; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000401:mortality / Q000628:therapy; D008297:Male; D009369:Neoplasms / Q000150:complications / Q000188:drug therapy* / Q000401:mortality; D006435:Renal Dialysis; D051436:Renal Insufficiency, Chronic / Q000150:complications / Q000401:mortality / Q000628:therapy*; D012189:Retrospective Studies; D015996:Survival Rate
chemical_list: D000970:Antineoplastic Agents