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C-KIN formal presentation 2015
1. Cancer & the Kidney
International Network
Dr. Vincent LAUNAY-VACHER
C-KIN President
Service ICAR
Pitié-Salpêtrière University Hospital, Paris, France
vincent.launay-vacher@psl.aphp.fr
3. Rationale
Is there any need for Cancer & Kidney disease
Education and Research ?
3
4. CKD is highly prevalent in
cancer patients (solid tumours)
France1,2: IRMA studies (1 and 2)
4’684 et 4’945 patients (all types of solid tumours)
eGFR<60 : 12.0% et 11.8%
Belgium3: BIRMA study
1’218 patients (all types of solid tumours)
eGFR<60 : 16.1%
United States4:
1’114 patients (kidney cancer)
eGFR<60 : 22,0%
Japan5:
231 patients (all types of solid tumours)
eGFR<60 : 25.0%
41Launay-Vacher V et al. Cancer 2007; 2Launay-Vacher V et al. Semin Nephrol 2010; 3Janus N et al. Br J Cancer 2010;
4Canter D et al. Urology. 2011; 5Nakamura Y et al. Nihon Jinzo Gakkai Shi. 2011;
CKD: Chronic Kidney Disease
eGFR: estimated Glomerular Filtration Rate
5. CKD is a risk factor for death in
cancer patients (solid tumours)
France1:
eGFR<60 => reduced overall survival HR 1.27 (p=0.0002)
Japan2 :
eGFR<60 = independent risk factor for death at 1 year
Korea3 :
30<eGFR<60 => HR for death 1.12 (p=0,04)
eGFR<30 => HR for death 1.75 (p<0,001)
51Launay-Vacher V et al. Semin Nephrol 2010;
2Nakamura Y et al. Nihon Jinzo Gakkai Shi. 2011;
3Na SY, et al. Am J Nephrol. 2011
6. CKD is a risk factor for death in
cancer patients (solid tumours)
1Launay-Vacher V et al. Semin Nephrol 2010;
2Na SY, et al. Am J Nephrol. 2011
6
aMDRD ≥ 60 (n=3720)
aMDRD < 60 (n=547)
p<0.0001
Ref. 1 Ref. 2
Cancer-related mortality
Reduced overall survival Increased cancer-related
mortality
7. CKD is a risk factor
for cancer death
71Iff S, et al. Am J Kidney Dis 2014
Population-based Australian study1:
4’077 patients, median follow-up of 12.8 years
eGFR<60 : independent risk factor for cancer death (CKD-EPI)
HR for cancer-related death = 1.27
Breast cancer: HR = 1.99
Urothelial cancers: HR = 2.54
Significant relationship between eGFR and cancer mortality
Each in eGFR of 10 ml/min/1.73m2 = 18% of cancer mortality (p=0.001)
Among patients with cancer
eGFR ≥ 75: Reference
eGFR 60-74: adjusted HR 1.55 [1.09-2.20]
eGFR 45-59: adjusted HR 1.42 [0.96-1.40]
eGFR < 45: adjusted HR 2.29 [1.43-3.69]
8. Rationale
Is there any need for Cancer & the Kidney
Education and Research ?
YES: CKD is highly prevalent in cancer patients
YES: CKD is associated with higher mortality
Reduced overall survival
Increased cancer-specific mortality
MARCH 2014: World Kidney Day
Official launch of the Cancer & the Kidney International
Network
8
9. Natural history of
« Cancer & the Kidney »
9
2005
Textbook
« Cancer and the Kidney »
1st Ed.
Oxford University Press
2007
1Launay-Vacher et al. 2010
4Launay-Vacher et al.
5Janus et al.
1Launay-Vacher V, et al. Cancer. 2007;110:1376-84; 2Launay-Vacher V. et al. Ann Oncol. 2007;18:1314-21; 3Lichtman SM. et al. Eur J Cancer. 2007;43:14-34; 4Launay-
Vacher V, et al. Semin Nephrol. 2010;30:548-56; 5Janus N, et al. Br J Cancer. 2010;103:1815-21; 6Canter D, et al. Urology. 2011;77:781-5; 7Nakamura Y, et al. Nihon Jinzo
Gakkai Shi. 2011;53(1):38-45; 8Na SY, et al. Am J Nephrol. 2011;33:121-30; 9Launay-Vacher V. Ann Oncol. 2013;24:2713-4
2011
6Canter et al.
7Nakamura et al.
8Na et al.
2013
9Invited Editorial
Annals of Oncology
2011
Textbook
« Cancer and the Kidney »
2nd Ed.
Oxford University Press
2014
ESO (European School of Oncology)
Special Course
« Cancer & the Kidney »
ResearchAwarenessEducation
2007
SIOG Guidelines
2Launay-Vacher et al.
3Lichtman et al.
10. C-KIN ORGANISATION
Not-for-profit organization
Executive Committee:
Vincent Launay-Vacher, France – President
Ben Sprangers, Belgium (Nephrology) – Treasurer
Matti Aapro, Switzerland (Oncology) – Secretary
Governing Board
Gilberto de Castro Jr, Brazil (Nephrology)
Eric Cohen, USA (Nephrology)
Gilbert Deray, France (Nephrology)
Michael Dooley, Australia (Clinical Pharmacy)
Benjamin Humphreys, USA (Nephrology)
Stuart Lichtman, USA (Oncology)
Jean-Baptiste Rey, France (Clinical Pharmacy)
Florian Scotté, France (Oncology)
Hans Wildiers, Belgium (Oncology)
10
11. C-KIN MEMBERSHIP
The aim of C-KIN is to improve patient care
Target audience thus includes all healthcare
professionnals involved and/or interested in:
The care of renal insufficiency cancer patients
The improvement of chemotherapies/targeted therapies renal
safety
The nephro-oncology multidisciplinary care of these patients
The pharmacological aspects and consequences of renal
insufficiency/kidney disease on recent or older oncology
drugs efficacy/safety
11
12. C-KIN MEMBERSHIP
The aim of C-KIN is to improve patient care
Target audience thus includes:
Oncologists
Hematologists
Supportive Care in Cancer specialists
Nephrologists
Radiotherapists
Clinical Pharmacists
…/…
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13. C-KIN ENDORSMENTS
C-KIN is officially endorsed by
4 joint sessions at C-KIN 2015 Annual Conference
13
14. C-KIN MISSION
Improving cancer patients care through better
knowledge on cancer and the kidney related issues,
through:
Education
Research
Practical tools
14
15. C-KIN MISSION
Improving cancer patients care through better
knowledge on cancer and the kidney related issues,
through:
Education
1st C-KIN Annual Conference, 14-15 April 2015, Brussels, BE
Literature monitoring (Members Library)
E-Learning program (in development)
15
16. C-KIN Conference 2015
1st C-KIN Annual Conference is endorsed by:
European Continuous Medical Education
accreditation is currently being submitted to:
The European Accreditation Council for Continuing Medical
Education – EACCME®
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17. C-KIN Conference 2015
17
1st Annual Conference
2 days of Education and Networking
3 Plenary Sessions
4 joint sessions with:
ASCO (American Society of Clinical Oncology)
EAHP (European Association of Hospital Pharmacists)
EORTC (European Organization for the Research and Treatment of Cancer)
SIOG (International Society of Geriatric Oncology)
5 Oral Communication and Posters
sessions
60 abstracts accepted
12 countries
18. C-KIN Conference 2015
Plenary 1. Cancer & the Kidney: Theory to Practice
How to Evaluate the Renal Function in Cancer Patients
How to Dose Carboplatin in CKD?
Cisplatin Renal Toxicity Prevention
Plenary 2. Targeted Therapies & the Kidney
Comparative Renal Safety Profiles of New and Ancient Cancer Therapies
BRAF in the Kidney: Does the target Make the Damage?
Renovascular Safety of Antiangiogenics: Update from the C-KIN Working Group
Plenary 3. Supportive Care & the Kidney
Anemia in Cancer Patients with CKD
The Specific Role of Antiemetics in Kidney Protection
Venous Thromboembolism, Cancer, and CKD : Update from C-KIN Working Group
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19. C-KIN Conference 2015
Countries of speakers for Plenaries and Main program sessions
France (8)
Belgium (3)
USA (3)
Switzerland (2)
Germany (1)
Netherlands (1)
UK (1)
Countries of abstract presenters (oral or posters)
France (14)
USA (12)
Belgium (11)
Italy (5)
Brazil (4)
.../...
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20. C-KIN MISSION
Improving cancer patients care through better
knowledge on cancer and the kidney related issues,
through:
Research
Joint Renal task force with EORTC
(European Organization for the Research and Treatment of Cancer)
First research project ongoing
Collaboration with EMA (European Medicine Agency)
Developing C-KIN clinical studies
20
21. C-KIN MISSION
Improving cancer patients care through better
knowledge on cancer and the kidney related issues,
through:
Practical tools
C-KIN membership includes a free access to SiteGPR®
(website providing evidence-based recommendations on drugs dosage adjustments in CKD)
Online estimation of renal function:
Simultaneous Cockcroft-Gault, MDRD, CKD-EPI
Automatic conversion from ml/min/1.73m2 into ml/min
800 drugs with dosage adjustment recommendations based on
the international literature
Clinical practice guidelines:
Developed within working groups activities
21
22. C-KIN Working Groups
2014-2015
1) Thrombosis, Cancer, and CKD
6 experts from Europe and Canada
Clinical practice guidelines expected end 2015
2) Antiangiogenics’ renovascular safety
Same organization
2015-2016
1) CINV prevention and cancer drugs renal toxicity
2) Anemia in cancer patients
22
23. Other organizations
on the same topic ?
American Society of Nephrology:
The Onco-Nephrology Forum (ONF)
Discussions between ONF and C-KIN
Several members in common
23
ONF C-KIN
USA International
Nephrologists Multidisciplinary
Basic science &
physiopathology
Clinically-oriented
Both organizations are not competing,
they are complementary
24. C-KIN Partnerships
C-KIN Corporate Membership
See « CKIN Corporate Member Benefits »
C-KIN 2015 Conference Sponsor
See « CKIN_Conference_Partnership_Opportunities_2015 »
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25. Partner with C-KIN to improve cancer patients’ care
25 to 40% of cancer patients have CKD
Cancer-related mortality more than doubled
There is much to do !
Dr. Vincent LAUNAY-VACHER
C-KIN President
Service ICAR
Pitié-Salpêtrière University Hospital Paris,
France
vincent.launay-vacher@psl.aphp.fr
C-KIN Global Headquarters
300 Avenue de Tervueren
1150 Brussels, Belgium
Tel : +32 (0)2 743 15 44
info@c-kin.org