Molecularly Targeted Cancer Medications and Kidney Health

Figures

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  Figure 1.. Cohort Generation of Treated Cohort and Matched Cohort A, Cohort generation of the treated cohort starting with extraction of patients ages 18 years and older at Stanford Medicine treated with cancer medications that are associated with an increase in serum creatinine at drug start or decreased creatinine secretion (8426 patients). We removed patients without a serum creatinine measurement between day 1 and 60 after drug start (3363 patients), and patients who already had an eGFR of 15 or less or required dialysis within 90 days before or within the first 60 days of drug start date (48 patients). This resulted in a final treated cohort of 5015 patients. B, Cohort generation of the matched cohort. Our starting cohort consisted of all patients at Stanford Medicine ages 18 years or older without any cancer concept identification (3 710 497 patients). We removed patients without any serum creatinine measurement (2 631 578 patients). Of those patients, we created a random 15% sample to allow more manageable computation (161 838 patients). We then removed patients from that sample without at least 2 serum creatinine measurements (107 239 patients) within any 2-year time frame. We then…

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  Figure 2.. Incidence Rates of Progressive Kidney Dysfunction in Treated and Matched Cohorts The incidence rate for our primary outcome (accounting for death and lost to follow-up) per 1000 person-years is shown on the y-axis. Drug classes on the x-axis refer to inhibitors. Due to wide confidence intervals, MET inhibitors results are reported in the text and not displayed here. MET inhibitors are included in overall treated group. ALK indicates anaplastic lymphoma kinase; BRAF, B-Raf proto-oncogene, serine/threonine kinase; CDK4/6, cyclin dependent kinase 4 or 6; EGFR, epidermal growth factor receptor; ERBB2, human epidermal growth factor receptor 2; PARP, poly(adenosine diphosphate-ribose) polymerase; VEGFR, vascular endothelial growth factor receptor.

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  Figure 3.. Adjusted Subdistribution Hazard Ratios for Progressive Kidney Dysfunction Within Each Drug Class as Compared With Propensity-Matched Cohort Without Cancer The subdistribution hazard ratios for progressive kidney dysfunction are shown for each drug group compared with their respective propensity score–matched cohort. The blue dots represent the hazard ratio and 95% CIs. Due to wide confidence intervals, MET inhibitors results reported in the text and not displayed here. MET inhibitors are included in overall treated group. Model is adjusted for hypertension, diabetes, ischemic heart disease, congestive heart failure, chronic obstructive pulmonary disease, cirrhosis, age, sex, race, body mass index, and eGFR before drug start. ALK indicates anaplastic lymphoma kinase; BRAF, B-Raf proto-oncogene, serine/threonine kinase; CDK4/6, cyclin dependent kinase 4 or 6; EGFR, epidermal growth factor receptor; ERBB2, human epidermal growth factor receptor 2; PARP, poly(adenosine diphosphate-ribose) polymerase; VEGFR, vascular endothelial growth factor receptor.