Carfilzomib-related acute kidney injury may be prevented by N-acetyl-L-cysteine

J Oncol Pharm Pract. 2015 Aug;21(4):313-6. doi: 10.1177/1078155214531804. Epub 2014 Apr 18.

Abstract

Carfilzomib is a second-generation epoxyketone proteasome inhibitor that is approved for treatment of relapsed and refractory multiple myeloma. Phase 2 trials have reported that 25% of treated patients have renal adverse effects. Pre-renal/vasoconstriction-related insult from this chemotherapy agent has been documented. We describe a case of a 78-year-old man with refractory multiple myeloma with acute kidney injury associated with carfilzomib treatment. We show that use of N-acetyl-l-cysteine in our patient partially mitigated the renal injury upon re-challenge. This case report hypothesizes that acute renal injury from carfilzomib is caused by vasoconstriction of the renal vessels, which may be prevented by N-acetyl-l-cysteine.

Keywords: Carfilzomib; N-acetyl-l-cysteine; acute renal failure; chemotherapy; kidney injury; myeloma.

Publication types

  • Case Reports

MeSH terms

  • Acetylcysteine / therapeutic use*
  • Acute Kidney Injury / chemically induced*
  • Acute Kidney Injury / diagnosis
  • Acute Kidney Injury / prevention & control*
  • Aged
  • Antineoplastic Agents / adverse effects
  • Humans
  • Male
  • Oligopeptides / adverse effects*

Substances

  • Antineoplastic Agents
  • Oligopeptides
  • carfilzomib
  • Acetylcysteine