When mesothelioma patients and their physicians discuss treatment plans, one of the most common topics is trade-offs. Almost every step forward in the status of their cancer might come at the cost of some other aspect of their health. One example is the kidney damage that often follows cisplatin-based chemotherapy treatment. But now Japanese researchers have identified a way to avoid that particular outcome.
Chemotherapy-Related Kidney Damage is Common in Mesothelioma
The most common treatment for malignant mesothelioma is a chemotherapy combination of cisplatin, a platinum-based drug, and Alimta (pemetrexed). But many patients who undergo this therapy end up with kidney damage. Japanese scientists set out to determine why this happens to some patients but not others, and have now linked a protein called megalin to the harmful adverse effect.
Researchers from Niigata University found that patients whose urine contains higher levels of megalin are at greater risk for kidney damage from cisplatin-based chemotherapy treatment. Megalin is a receptor protein that regulates the uptake of other proteins and lipids. It is found on the surface of some epithelial cells, including those of the kidneys. The researchers determined that the higher levels of this protein in the urine of mesothelioma patients prior to chemotherapy is predictive for kidney damage after the therapy.
The Higher the Levels, the Greater the Risk
According to study author Satoshi Shoji, almost four dozen patients diagnosed with either pleural mesothelioma or lung cancer provided urine samples prior to chemotherapy so that scientists could assess their megalin levels. Writing in the scientific journal BMC Cancer, he says, “A negative correlation was found between baseline urinary A-megalin levels and change in eGFR [a measure of kidney function].”
This information is invaluable in helping physicians as they devise treatment plans for their mesothelioma patients. By ordering a simple urine test for megalin, doctors can see which patients are at greatest risk for kidney damage and choose to pursue alternative therapies.
Treating malignant mesothelioma is a delicate balance. For information about the options available and the best treatment centers, contact the Patient Advocates at Mesothelioma.net at 1-800-692-8608.