Abstract: TH-PO1292
eGFR Difference and Platinum-Associated Adverse Events in Patients with Cancer
Session Information
- Late-Breaking Research Posters
October 22, 2026 | Location: Exhibit Hall A, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Onconephrology
- 1600 Onconephrology
Authors
- Lyu, Jiaxuan, Massachusetts General Hospital, Boston, Massachusetts, United States
- Khor, Si Yuan, Massachusetts General Hospital, Boston, Massachusetts, United States
- Ouyang, Tianqi, Massachusetts General Hospital, Boston, Massachusetts, United States
- Mejia, Sherley M., Massachusetts General Hospital, Boston, Massachusetts, United States
- Specht, Katherine C., Massachusetts General Hospital, Boston, Massachusetts, United States
- Moreno, Daiana R., Massachusetts General Hospital, Boston, Massachusetts, United States
- Seethapathy, Harish Shanthanu, Massachusetts General Hospital, Boston, Massachusetts, United States
- Hanna, Paul, Mayo Clinic in Florida, Jacksonville, Florida, United States
- Zubiri Oteiza, Leyre, Massachusetts General Hospital, Boston, Massachusetts, United States
- Mistry, Kavita, Beth Israel Deaconess Medical Center, Boston, Massachusetts, United States
- Katz, Nurit S., VA Boston Healthcare System, West Roxbury, Massachusetts, United States
- Lei, Matthew, Massachusetts General Hospital, Boston, Massachusetts, United States
- Temel, Jennifer S., Massachusetts General Hospital, Boston, Massachusetts, United States
- Fintelmann, Florian J., Massachusetts General Hospital, Boston, Massachusetts, United States
- Shah, Sachin J., Massachusetts General Hospital, Boston, Massachusetts, United States
- Inker, Lesley, Tufts Medical Center, Boston, Massachusetts, United States
- Sise, Meghan E., Massachusetts General Hospital, Boston, Massachusetts, United States
Background
Creatinine-based eGFR commonly overestimates true GFR in patients with cancer; eGFR calculated using creatinine and cystatin C (eGFR-CR-CYS) is more precise and accurate. We hypothesized that having an eGFR-CR-CYS that is lower than Cockcroft-Gault creatinine clearance (dosing equation) would be associated with an increased risk for adverse events (AEs) within 90 days after initiation of cis- or carboplatin.
Methods
Prospective study of consecutive adults beginning cis- or carboplatin or cancer from 2023-2025 followed for 90 days with a research-only cystatin C obtained just prior to first dose. We determined the association between the eGFR difference (%) between eGFR-CR-CYS and Cockcroft-Gault (dosing equation) with the risk of being hospitalized for a platinum-associated AEs, all-cause hospitalization, grade ≥3 cytopenias, and acute kidney injury (AKI) using a Fine-Gray model and death using a Cox model. For carboplatin-treated patients, we defined the dose difference as the administered dose minus the eGFR-CR-CYS-predicted dose using the Calvert equation and determined the association between the dose difference and each of the outcomes.
Results
Of 943 consecutive adults beginning cis- or carboplatin, each 10% decline in eGFR difference was associated with an independently increased risk of hospitalization for a platinum-associated AE (sHR 1.39 per 10% decline, 95% CI 1.24–1.56). Risks of all secondary outcomes were increased: all-cause hospitalization (sHR 1.22, 95% CI 1.11–1.33), grade ≥3 anemia (sHR 1.38, 95% CI 1.18–1.57), grade ≥3 thrombocytopenia (sHR 1.57, 95% CI 1.28–1.92), AKI (sHR 1.35, 95% CI 1.17–1.56), and mortality (HR 1.70, 95% CI 1.35–2.13) per 10% decline in eGFR difference (Figure). Each 25mg increase in the dose of carboplatin administered compared to the dose predicted by eGFR-CR-CYS was associated with a 1.15-fold increased risk of hospitalization for platinum-associated AE (95% CI 1.04-1.27, per 25mg).
Conclusion
There is a continuous, independent association between eGFR difference and platinum-associated AEs in patients with cancer.
Funding
- Other NIH Support