Individualized treatment and pharmaceutical care for breast cancer complicated with chronic kidney disease
- VernacularTitle:乳腺癌伴慢性肾脏病患者的个体化治疗与药学监护
- Author:
Lu YU
1
;
Xudong WU
2
;
Ming ZHANG
1
Author Information
1. Dept. of Clinical Pharmacy，Ningbo Yinzhou District No.2 Hospital，Zhejiang Ningbo 315100，China
2. Dept. of Internal Medicine，Zhonggongmiao Community Hospital of Ningbo Yinzhou District No.2 Hospital Medical Community，Zhejiang Ningbo 315100，China
- Publication Type:Journal Article
- Keywords:
breast cancer;
chronic kidney disease;
preoperative neoadjuvant treatment;
postoperative targeted therapy;
clinical
- From:
China Pharmacy
2025;36(7):853-857
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVE To provide a reference for individualized treatment and pharmaceutical care for patients with breast cancer complicated with chronic kidney disease （CKD）. METHODS Clinical pharmacists participated in the anti-tumor treatment and pharmaceutical care for a breast cancer patient with CKD. Clinical pharmacists reviewed guidelines and literature to assist the clinical physician in formulating the initial neoadjuvant treatment plan （docetaxel+trastuzumab+paltuzumab） and provided monitoring recommendations for potential adverse drug reactions， such as vomiting， myelosuppression， renal impairment， cardiotoxicity. In response to the patient’s acute kidney injury after treatment， clinical pharmacists assisted the physician in analyzing the cause of the adverse reaction through causality assessment. Taking into account the patient’s preferences， docetaxel was substituted with paclitaxel （which did not require dose adjustment based on renal function）. The clinical pharmacists collaborated with the physician to establish a postoperative targeted therapy regimen （trastuzumab+pertuzumab）. Taking into account the patient’s positive estrogen receptor status， the clinical pharmacists recommended to initiate regular anastrozole administration after the completion of radiotherapy and undergo periodic bone density assessments. RESULTS The clinical physician accepted the suggestions from the clinical pharmacists. The patient successfully completed preoperative neoadjuvant chemotherapy and postoperative targeted therapy， and was discharged with medication （anastrozole）. During the treatment process， the patient did not experience adverse reactions such as myelosuppression， cardiotoxicity， or the occurrence of osteoporosis. CONCLUSIONS Clinical pharmacists analyzed and adjusted the preoperative and postoperative antitumor treatment plans based on the patient’s renal function. They promptly assessed the correlation between antitumor drugs and acute kidney injury， and actively implemented comprehensive pharmaceutical care to ensure medication safety for breast cancer patients with CKD.
