Chemotherapy for Patients with Renal Dysfunction

Significant progress has been made in systemic chemotherapies for advanced cancer patients. Historically, the main anticancer drugs were cytotoxic agents, but recently, other agents such as molecularly-targeted therapies and immune checkpoint inhibitors have been introduced into clinical practice, and these agents have begun to achieve mainstream usage. The rapid development of novel anticancer drugs has forced clinicians to consider the effects of these chemotherapy agents in high-risk patients with liver or renal dysfunction, those undergoing dialysis and the elderly. Currently, there are no clear guidelines describing the best practices for anticancer drug administration in patients with renal dysfunction. However, the theory that renal dysfunction affects the ability of patients to cope with anticancer therapies is understandable compared with liver dysfunction or other risk factors. That is why there has always been an indication for dose adjustments for patients with renal dysfunction. In this review, recommended dose adjustments in cases of renal dysfunction are discussed based on the latest information on anticancer drugs.