Effect of PARP Inhibitors on Glomerular Filtration Rate

University of Pennsylvania2 enrolled

Overview

The purpose of this study is to observe whether PARP inhibitors have an effect on serum creatinine level, and whether this reflects a change in creatinine secretion or a true change in kidney function.

PARPi medications interact with transporters along the renal tubules involved in the secretion of creatinine and an increase in serum creatinine is often observed in patients treated with these agents; however, it is not known whether PARP inhibitors are associated with an actual change in the glomerular filtration rate, or if the observed elevations of serum creatinine are a result of a drug effect on creatinine secretion unrelated to changes in kidney function. The investigators therefore propose a prospective observational study to examine the incidence of elevation in serum creatinine from baseline levels in patients initiated on PARP inhibitors and compare the estimated glomerular filtration rate based on creatinine to that from alternative tests. The primary purposes of this study are to: * Assess the incidence of increase in serum creatinine in patients with a solid-organ cancer on treatment with a PARP inhibitor. * To compare the estimated glomerular filtration rate based on serum creatinine with that of alternative biomarkers to assess whether changes in serum creatinine reflect changes in kidney function or creatinine secretion. * To examine the persistence or resolution of creatinine increase and/or GFR decrease noted after discontinuation of PARPi

Study Type

OBSERVATIONAL

Enrollment

Conditions

Solid Tumor Ovarian Cancer Breast Cancer

Interventions

Kidney Function TestOTHER

Cystatin-C measurement

Eligibility

Sex: ALLMin age: 18 YearsHealthy volunteers:

Medical Language ↔ Plain English

Inclusion Criteria: * Adult patients age 18 years or older * Diagnosed with any solid organ cancer * Planned to receive a PARP inhibitor (olaparib, niraparib, rucaparib, veliparib, or talazoparib) * Able to consent to study related procedures * If unable to give informed consent, must have healthcare proxy or legally authorized representative * Fluent in conversational English (Informed Consent form currently in English language) Exclusion Criteria: * Patients who will not receive ongoing cancer care at Penn Medicine * Major psychiatric illness or cognitive impairment that in the judgment of the study investigators or study staff would preclude study participation * Any patients who are unable to comply with the study procedures as determined by the study investigators or study staff * Patients on dialysis

Locations (1)

University of Pennsylvania

Philadelphia, Pennsylvania, United States

Outcomes

Primary Outcomes

Change in eGFR from Baseline to On-Treatment, 3-9 weeks after PARPi Initiation (Time Point B)

Change in eGFR from baselineto on-treatment by ≥20% as measured using either cystatin C or 24h urine collection

Time frame: Study labs will be obtained within 3-9 weeks after PARPi is initiated

Secondary Outcomes

Within 4 Weeks of Post-discontinuation of PARPi (Time Point C) for patients with clinically significant changes in eGFR based on serum creatinine, cystatin C, or 24 hour urinalysis at Timepoint B

The percentage of patients who experience a eGFR reduction of ≥30%, and/or

Time frame: Post-treatment (within 4 weeks of PARP inhibitor discontinuation, only for those patients with clinically significant changes in GFR based on serum creatinine, cystatin C, or 24 hour urinalysis at Timepoint B

Data from ClinicalTrials.gov

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