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Chang Youl Lee

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    MA16 - Prioritizing Use of Technology to Improve Survival of Lung Cancer Subgroups and Outcomes with Chemotherapy and Surgery (ID 142)

    • Event: WCLC 2019
    • Type: Mini Oral Session
    • Track: Treatment in the Real World - Support, Survivorship, Systems Research
    • Presentations: 1
    • Now Available
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      MA16.10 - Antioxidative Effect of Erdosteine on Platinum-Based Doublet Chemotherapy Induced Nephrotoxicity (Now Available) (ID 1080)

      15:45 - 17:15  |  Presenting Author(s): Chang Youl Lee

      • Abstract
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      Many classes of antineoplastic agents including the platinum coordination complexes are also known to generate free radicals which have a role in the side effects of chemotherapy. Despite the introduction of new treatments including target and immunotherapy, platinum-based doublet chemotherapy is one of the most widely used and most potent chemotherapy drugs to treat lung cancer patients especially with small cell lung cancer. However, side effects in normal tissues and organs, notably nephrotoxicity in the kidneys, limit the use of platinum-based doublet chemotherapy. There are several experimental evidences which support the protective effect of erdosteine in acute injury induced by a variety of pharmacological or noxious agents, mediated by products of oxidative stress. Erdosteine is a multifactorial drug currently used in lung disease. In the last decade, data from several studies to the possible antitussive and anti-inflammatory properties of erdosteine and an indirect anti-inflammatory mechanism of action related to the ROS scavenging activity was suggested. The purpose of this study is to investigate whether erdostein can reduce the renal toxicity of lung cancer with platinum-based doublet chemotherapy by antioxidant role.


      This study was a prospective, randomized, double-blind clinical trial on 153 patients with lung cancer(small cell lung cancer and non-small cell lung cancer). Patients who was treated with platinum-based doublet chemotherapy were randomly assigned into 2 groups of intervention(erdostein) group and control(non-erdostein) subjects regardless of the type of lung cancer. Intervention group took erdosteine 600 mg orally twice a day. We measured CCr, serum/urine NGAL, serum/urine Cystatin C, urine KIM-1 of the lung cancer patients who underwent platinum-based doublet chemotherapy to assess renal injury. And also we measured the activity of specific antioxidant enzymes, such as catalase and superoxide dismutase to evaluate oxidative stress. Serum and urine samples were collected from the patient before and after chemotherapy.


      There was no significant difference of renal status between intervention and control groups at baseline. However, Statistically there was a significant decline in CCr among control group regardless of the type of lung cancer and the resimen of chemotherapy. NGAL expression of blood and urine was decreased in intervention group (especially patient treated with cisplatin and small cell lung carcer patients) but Cystatin C levels showed no difference between two groups. The decrease in urinary KIM-1 after cisplatin-based doublet chemotherapy in intervention group were observed compared to control group. Superoxide dismutase levels of serum were approximately increased to twice the initial level to the level measured after chemotherapy in the treatment group while the level of catalase did not change significantly in both the groups.


      These results show that erdosteine may be a promising drug for protection against platinum-based doublet chemotherapy-induced nephrotoxicity, especially for patients with cisplatin-based doublet chemotherapy and small cell lung cancer. However, further studies with different dose of erdosteine are warranted for clarifying the issue.

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