Representation of Patients With Chronic Kidney Disease in Trials of Cancer Therapy

Chronic kidney disease (CKD) is common in patients with cancer, with reported prevalence ranging from 12% to 53% at cancer diagnosis. 1 Cancer patients with concomitant CKD have worse cancer outcomes than those with normal kidney function. 2 Despite the prevalence of kidney dysfunction and its prognostic implications, there is limited evidence to guide cancer treatment in patients with CKD. One reason may be the exclusion of CKD patients from clinical trials (as has been documented in cardiovascular studies). We sought to quantify and characterize the exclusion of patients with CKD in randomized clinical trials of anticancer drugs.