Urinalysis by combination of the dipstick test and urine protein–creatinine ratio (UPCR) assessment can prevent unnecessary lenvatinib interruption in patients with thyroid cancer
Background Proteinuria induced by lenvatinib is a class effect that occurs secondary to VEGFR suppression. Withholding of lenvatinib is required in cases with severe proteinuria. Urine protein–creatinine ratio (UPCR, g/gCre) has recently attracted attention as an alternative to 24-h urine collection...
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| Veröffentlicht in: | International journal of clinical oncology 2020-07, Vol.25 (7), p.1278-1284 |
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| container_title | International journal of clinical oncology |
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| creator | Masaki, Chie Sugino, Kiminori Kobayashi, Sakiko Akaishi, Junko Hames, Kiyomi Y. Tomoda, Chisato Suzuki, Akifumi Matsuzu, Kenichi Uruno, Takashi Ohkuwa, Keiko Kitagawa, Wataru Nagahama, Mitsuji Ito, Koichi |
| description | Background
Proteinuria induced by lenvatinib is a class effect that occurs secondary to VEGFR suppression. Withholding of lenvatinib is required in cases with severe proteinuria. Urine protein–creatinine ratio (UPCR, g/gCre) has recently attracted attention as an alternative to 24-h urine collection for assessing proteinuria. The aim of this study was to examine the correlation between the results of proteinuria assessed by the dipstick test and UPCR, and to investigate the influence of proteinuria grading with UPCR on lenvatinib dose adjustment compared to that with only the dipstick test.
Method
Three hundred and ten urine samples from 63 patients with advanced thyroid cancer under treatment with lenvatinib, which were tested by both the dipstick test and UPCR were analyzed. Lenvatinib was withheld when there was evidence of CTCAE grade 3 proteinuria, and restarted when it resolved. The frequency of proteinuria, correlation between the results of the dipstick test and UPCR test, and the effect of dose withholding in cases with results of 3 + in the dipstick test were calculated.
Results
Proteinuria was seen in 56 (88.9%) patients. Of the 154 dipstick 3 + samples, only 56 (36.4%) were judged as more than 3.5 g/gCre by UPCR (grade 3 proteinuria), although none of the 1 + and only 3.7% of 2 + samples were judged as grade 3 proteinuria. We were able to prevent unnecessary lenvatinib interruption due to proteinuria in 63.6% of dipstick 3 + samples by assessment of UPCR.
Conclusions
Urinalysis by combination of the dipstick test and UPCR assessment might be a better strategy for preventing unnecessary interruption of lenvatinib. |
| doi_str_mv | 10.1007/s10147-020-01678-x |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2396303332</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2419210022</sourcerecordid><originalsourceid>FETCH-LOGICAL-c399t-e7dfcde7b7bc25be5a578e7a219664809cf9ef1ca4e51ef8f38a843dd1bd093e3</originalsourceid><addsrcrecordid>eNp9kc9u1DAQxi0EomXhBTggS1zKIcX_EidHtIKCVKkIsWfLcSbUJXEW22m7t74Dz8IL8SRMdgtIHDjZnvl9M575CHnO2SlnTL9OnHGlCyZYwXil6-L2ATnmSupCay0e4l0qXjSVKI_Ik5SuGOO6KsVjciSFVFpJcUx-bKIPdtgln2i7o24aW3xnPwU69TRfAu38NmXvvtIMKVMbOjqjBOg2Thl8-Hn33UVARViCcZHSk83H9adX1KYEKY0QMnU2oACul_scAjhM2LijA4TrvbalPmSIcd7ue3vEMY54ojc-X-JPdnHy3VLIQXxKHvV2SPDs_lyRzbu3n9fvi_OLsw_rN-eFk02TC9Bd7zrQrW6dKFsobalr0FbwpqpUzRrXN9BzZxWUHPq6l7Wtlew63naskSBX5ORQF4f9NuP8ZvTJwTDYANOcjJBNJZmUuM8VefkPejXNEVeLlOKNQMfEQokD5eKUUoTebKMfcROGM7OYag6mGjTV7E01tyh6cV96bkfo_kh-u4iAPAAJU-ELxL-9_1P2F3NPtBY</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2419210022</pqid></control><display><type>article</type><title>Urinalysis by combination of the dipstick test and urine protein–creatinine ratio (UPCR) assessment can prevent unnecessary lenvatinib interruption in patients with thyroid cancer</title><source>SpringerLink Journals - AutoHoldings</source><creator>Masaki, Chie ; Sugino, Kiminori ; Kobayashi, Sakiko ; Akaishi, Junko ; Hames, Kiyomi Y. ; Tomoda, Chisato ; Suzuki, Akifumi ; Matsuzu, Kenichi ; Uruno, Takashi ; Ohkuwa, Keiko ; Kitagawa, Wataru ; Nagahama, Mitsuji ; Ito, Koichi</creator><creatorcontrib>Masaki, Chie ; Sugino, Kiminori ; Kobayashi, Sakiko ; Akaishi, Junko ; Hames, Kiyomi Y. ; Tomoda, Chisato ; Suzuki, Akifumi ; Matsuzu, Kenichi ; Uruno, Takashi ; Ohkuwa, Keiko ; Kitagawa, Wataru ; Nagahama, Mitsuji ; Ito, Koichi</creatorcontrib><description>Background
Proteinuria induced by lenvatinib is a class effect that occurs secondary to VEGFR suppression. Withholding of lenvatinib is required in cases with severe proteinuria. Urine protein–creatinine ratio (UPCR, g/gCre) has recently attracted attention as an alternative to 24-h urine collection for assessing proteinuria. The aim of this study was to examine the correlation between the results of proteinuria assessed by the dipstick test and UPCR, and to investigate the influence of proteinuria grading with UPCR on lenvatinib dose adjustment compared to that with only the dipstick test.
Method
Three hundred and ten urine samples from 63 patients with advanced thyroid cancer under treatment with lenvatinib, which were tested by both the dipstick test and UPCR were analyzed. Lenvatinib was withheld when there was evidence of CTCAE grade 3 proteinuria, and restarted when it resolved. The frequency of proteinuria, correlation between the results of the dipstick test and UPCR test, and the effect of dose withholding in cases with results of 3 + in the dipstick test were calculated.
Results
Proteinuria was seen in 56 (88.9%) patients. Of the 154 dipstick 3 + samples, only 56 (36.4%) were judged as more than 3.5 g/gCre by UPCR (grade 3 proteinuria), although none of the 1 + and only 3.7% of 2 + samples were judged as grade 3 proteinuria. We were able to prevent unnecessary lenvatinib interruption due to proteinuria in 63.6% of dipstick 3 + samples by assessment of UPCR.
Conclusions
Urinalysis by combination of the dipstick test and UPCR assessment might be a better strategy for preventing unnecessary interruption of lenvatinib.</description><identifier>ISSN: 1341-9625</identifier><identifier>EISSN: 1437-7772</identifier><identifier>DOI: 10.1007/s10147-020-01678-x</identifier><identifier>PMID: 32347432</identifier><language>eng</language><publisher>Singapore: Springer Singapore</publisher><subject>Cancer Research ; Creatinine ; Medicine ; Medicine & Public Health ; Oncology ; Original Article ; Proteinuria ; Surgical Oncology ; Thyroid cancer ; Urinalysis ; Urine ; Vascular endothelial growth factor receptors</subject><ispartof>International journal of clinical oncology, 2020-07, Vol.25 (7), p.1278-1284</ispartof><rights>Japan Society of Clinical Oncology 2020</rights><rights>Japan Society of Clinical Oncology 2020.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c399t-e7dfcde7b7bc25be5a578e7a219664809cf9ef1ca4e51ef8f38a843dd1bd093e3</citedby><cites>FETCH-LOGICAL-c399t-e7dfcde7b7bc25be5a578e7a219664809cf9ef1ca4e51ef8f38a843dd1bd093e3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s10147-020-01678-x$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s10147-020-01678-x$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32347432$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Masaki, Chie</creatorcontrib><creatorcontrib>Sugino, Kiminori</creatorcontrib><creatorcontrib>Kobayashi, Sakiko</creatorcontrib><creatorcontrib>Akaishi, Junko</creatorcontrib><creatorcontrib>Hames, Kiyomi Y.</creatorcontrib><creatorcontrib>Tomoda, Chisato</creatorcontrib><creatorcontrib>Suzuki, Akifumi</creatorcontrib><creatorcontrib>Matsuzu, Kenichi</creatorcontrib><creatorcontrib>Uruno, Takashi</creatorcontrib><creatorcontrib>Ohkuwa, Keiko</creatorcontrib><creatorcontrib>Kitagawa, Wataru</creatorcontrib><creatorcontrib>Nagahama, Mitsuji</creatorcontrib><creatorcontrib>Ito, Koichi</creatorcontrib><title>Urinalysis by combination of the dipstick test and urine protein–creatinine ratio (UPCR) assessment can prevent unnecessary lenvatinib interruption in patients with thyroid cancer</title><title>International journal of clinical oncology</title><addtitle>Int J Clin Oncol</addtitle><addtitle>Int J Clin Oncol</addtitle><description>Background
Proteinuria induced by lenvatinib is a class effect that occurs secondary to VEGFR suppression. Withholding of lenvatinib is required in cases with severe proteinuria. Urine protein–creatinine ratio (UPCR, g/gCre) has recently attracted attention as an alternative to 24-h urine collection for assessing proteinuria. The aim of this study was to examine the correlation between the results of proteinuria assessed by the dipstick test and UPCR, and to investigate the influence of proteinuria grading with UPCR on lenvatinib dose adjustment compared to that with only the dipstick test.
Method
Three hundred and ten urine samples from 63 patients with advanced thyroid cancer under treatment with lenvatinib, which were tested by both the dipstick test and UPCR were analyzed. Lenvatinib was withheld when there was evidence of CTCAE grade 3 proteinuria, and restarted when it resolved. The frequency of proteinuria, correlation between the results of the dipstick test and UPCR test, and the effect of dose withholding in cases with results of 3 + in the dipstick test were calculated.
Results
Proteinuria was seen in 56 (88.9%) patients. Of the 154 dipstick 3 + samples, only 56 (36.4%) were judged as more than 3.5 g/gCre by UPCR (grade 3 proteinuria), although none of the 1 + and only 3.7% of 2 + samples were judged as grade 3 proteinuria. We were able to prevent unnecessary lenvatinib interruption due to proteinuria in 63.6% of dipstick 3 + samples by assessment of UPCR.
Conclusions
Urinalysis by combination of the dipstick test and UPCR assessment might be a better strategy for preventing unnecessary interruption of lenvatinib.</description><subject>Cancer Research</subject><subject>Creatinine</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Oncology</subject><subject>Original Article</subject><subject>Proteinuria</subject><subject>Surgical Oncology</subject><subject>Thyroid cancer</subject><subject>Urinalysis</subject><subject>Urine</subject><subject>Vascular endothelial growth factor receptors</subject><issn>1341-9625</issn><issn>1437-7772</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>8G5</sourceid><sourceid>BENPR</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNp9kc9u1DAQxi0EomXhBTggS1zKIcX_EidHtIKCVKkIsWfLcSbUJXEW22m7t74Dz8IL8SRMdgtIHDjZnvl9M575CHnO2SlnTL9OnHGlCyZYwXil6-L2ATnmSupCay0e4l0qXjSVKI_Ik5SuGOO6KsVjciSFVFpJcUx-bKIPdtgln2i7o24aW3xnPwU69TRfAu38NmXvvtIMKVMbOjqjBOg2Thl8-Hn33UVARViCcZHSk83H9adX1KYEKY0QMnU2oACul_scAjhM2LijA4TrvbalPmSIcd7ue3vEMY54ojc-X-JPdnHy3VLIQXxKHvV2SPDs_lyRzbu3n9fvi_OLsw_rN-eFk02TC9Bd7zrQrW6dKFsobalr0FbwpqpUzRrXN9BzZxWUHPq6l7Wtlew63naskSBX5ORQF4f9NuP8ZvTJwTDYANOcjJBNJZmUuM8VefkPejXNEVeLlOKNQMfEQokD5eKUUoTebKMfcROGM7OYag6mGjTV7E01tyh6cV96bkfo_kh-u4iAPAAJU-ELxL-9_1P2F3NPtBY</recordid><startdate>20200701</startdate><enddate>20200701</enddate><creator>Masaki, Chie</creator><creator>Sugino, Kiminori</creator><creator>Kobayashi, Sakiko</creator><creator>Akaishi, Junko</creator><creator>Hames, Kiyomi Y.</creator><creator>Tomoda, Chisato</creator><creator>Suzuki, Akifumi</creator><creator>Matsuzu, Kenichi</creator><creator>Uruno, Takashi</creator><creator>Ohkuwa, Keiko</creator><creator>Kitagawa, Wataru</creator><creator>Nagahama, Mitsuji</creator><creator>Ito, Koichi</creator><general>Springer Singapore</general><general>Springer Nature B.V</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7TO</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>H94</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>M2O</scope><scope>MBDVC</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>7X8</scope></search><sort><creationdate>20200701</creationdate><title>Urinalysis by combination of the dipstick test and urine protein–creatinine ratio (UPCR) assessment can prevent unnecessary lenvatinib interruption in patients with thyroid cancer</title><author>Masaki, Chie ; Sugino, Kiminori ; Kobayashi, Sakiko ; Akaishi, Junko ; Hames, Kiyomi Y. ; Tomoda, Chisato ; Suzuki, Akifumi ; Matsuzu, Kenichi ; Uruno, Takashi ; Ohkuwa, Keiko ; Kitagawa, Wataru ; Nagahama, Mitsuji ; Ito, Koichi</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c399t-e7dfcde7b7bc25be5a578e7a219664809cf9ef1ca4e51ef8f38a843dd1bd093e3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Cancer Research</topic><topic>Creatinine</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Oncology</topic><topic>Original Article</topic><topic>Proteinuria</topic><topic>Surgical Oncology</topic><topic>Thyroid cancer</topic><topic>Urinalysis</topic><topic>Urine</topic><topic>Vascular endothelial growth factor receptors</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Masaki, Chie</creatorcontrib><creatorcontrib>Sugino, Kiminori</creatorcontrib><creatorcontrib>Kobayashi, Sakiko</creatorcontrib><creatorcontrib>Akaishi, Junko</creatorcontrib><creatorcontrib>Hames, Kiyomi Y.</creatorcontrib><creatorcontrib>Tomoda, Chisato</creatorcontrib><creatorcontrib>Suzuki, Akifumi</creatorcontrib><creatorcontrib>Matsuzu, Kenichi</creatorcontrib><creatorcontrib>Uruno, Takashi</creatorcontrib><creatorcontrib>Ohkuwa, Keiko</creatorcontrib><creatorcontrib>Kitagawa, Wataru</creatorcontrib><creatorcontrib>Nagahama, Mitsuji</creatorcontrib><creatorcontrib>Ito, Koichi</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Oncogenes and Growth Factors Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>ProQuest Public Health Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>ProQuest Research Library</collection><collection>Research Library (Corporate)</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><jtitle>International journal of clinical oncology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Masaki, Chie</au><au>Sugino, Kiminori</au><au>Kobayashi, Sakiko</au><au>Akaishi, Junko</au><au>Hames, Kiyomi Y.</au><au>Tomoda, Chisato</au><au>Suzuki, Akifumi</au><au>Matsuzu, Kenichi</au><au>Uruno, Takashi</au><au>Ohkuwa, Keiko</au><au>Kitagawa, Wataru</au><au>Nagahama, Mitsuji</au><au>Ito, Koichi</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Urinalysis by combination of the dipstick test and urine protein–creatinine ratio (UPCR) assessment can prevent unnecessary lenvatinib interruption in patients with thyroid cancer</atitle><jtitle>International journal of clinical oncology</jtitle><stitle>Int J Clin Oncol</stitle><addtitle>Int J Clin Oncol</addtitle><date>2020-07-01</date><risdate>2020</risdate><volume>25</volume><issue>7</issue><spage>1278</spage><epage>1284</epage><pages>1278-1284</pages><issn>1341-9625</issn><eissn>1437-7772</eissn><abstract>Background
Proteinuria induced by lenvatinib is a class effect that occurs secondary to VEGFR suppression. Withholding of lenvatinib is required in cases with severe proteinuria. Urine protein–creatinine ratio (UPCR, g/gCre) has recently attracted attention as an alternative to 24-h urine collection for assessing proteinuria. The aim of this study was to examine the correlation between the results of proteinuria assessed by the dipstick test and UPCR, and to investigate the influence of proteinuria grading with UPCR on lenvatinib dose adjustment compared to that with only the dipstick test.
Method
Three hundred and ten urine samples from 63 patients with advanced thyroid cancer under treatment with lenvatinib, which were tested by both the dipstick test and UPCR were analyzed. Lenvatinib was withheld when there was evidence of CTCAE grade 3 proteinuria, and restarted when it resolved. The frequency of proteinuria, correlation between the results of the dipstick test and UPCR test, and the effect of dose withholding in cases with results of 3 + in the dipstick test were calculated.
Results
Proteinuria was seen in 56 (88.9%) patients. Of the 154 dipstick 3 + samples, only 56 (36.4%) were judged as more than 3.5 g/gCre by UPCR (grade 3 proteinuria), although none of the 1 + and only 3.7% of 2 + samples were judged as grade 3 proteinuria. We were able to prevent unnecessary lenvatinib interruption due to proteinuria in 63.6% of dipstick 3 + samples by assessment of UPCR.
Conclusions
Urinalysis by combination of the dipstick test and UPCR assessment might be a better strategy for preventing unnecessary interruption of lenvatinib.</abstract><cop>Singapore</cop><pub>Springer Singapore</pub><pmid>32347432</pmid><doi>10.1007/s10147-020-01678-x</doi><tpages>7</tpages></addata></record> |
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| subjects | Cancer Research Creatinine Medicine Medicine & Public Health Oncology Original Article Proteinuria Surgical Oncology Thyroid cancer Urinalysis Urine Vascular endothelial growth factor receptors |
| title | Urinalysis by combination of the dipstick test and urine protein–creatinine ratio (UPCR) assessment can prevent unnecessary lenvatinib interruption in patients with thyroid cancer |
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