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Possible protective effect of pantoprazole against cisplatin-induced nephrotoxicity in head and neck cancer patients: a randomized controlled trial

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Abstract

Cisplatin is used to treat solid malignancies including head and neck cancer. However, nephrotoxicity limits its use. In this study, we looked for a possible protective effect of pantoprazole against cisplatin-induced nephrotoxicity. We used novel biomarkers for early detection of nephrotoxicity. Sixty chemotherapy naïve head and neck cancer patients completed the study. Following complete history taking and thorough clinical examination, patients were randomly divided into three groups: 20 patients in each. Group I (control group) received cisplatin without pantoprazole, groups II and III received pantoprazole 80 mg and 40 mg, respectively, concurrently with cisplatin. Blood and urine samples were collected at baseline, and 48 h after the first and third cycles of cisplatin administration. Assessment of serum creatinine and soluble FasL (sFasL), as well as urinary neutrophil gelatinase-associated lipocalin (NGAL) and kidney injury molecule-1 (KIM-1) was performed. Nephrotoxicity was detected in 6 patients in group I, none in group II and 3 patients in group III. Serum creatinine significantly increased at the end of treatment in group I compared to groups II and III. Group I also had significantly higher urinary KIM-1 and NGAL and serum sFasL compared to groups II and III after the first and third cycles. On the contrary, there was no significant difference between groups II and III. Pantoprazole prevented the increase in acute kidney injury biomarkers in cisplatin-treated patients. Therefore, it is a promising agent in reducing cisplatin-induced nephrotoxicity.

Trial registration Clinical Trials.gov identifier: NCT04217512, registered in January 2020 " retrospectively registered".

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Acknowledgements

The authors are grateful for physicians of Oncology and Nuclear Medicine department at Menoufia University hospital for their help during patient allocation. We are also grateful for Faculty of Pharmacy, Tanta University for encouraging this research.

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No funds, grants, or other support was received.

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Authors and Affiliations

  1. Clinical Pharmacy Department, Faculty of Pharmacy, Tanta University, El-Guiesh Street, El-Gharbia Governorate, Tanta, 31111, Egypt

    Eman Ghonaim & Sahar El-Haggar

  2. Oncology and Nuclear Medicine Department, Faculty of Medicine, Menoufia University, Yassin Abd-Elghaffar St. From Gamal Abdel Nasser ST., Shebin El-Kom, 32511, Menoufia, Egypt

    Suzy Gohar

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Contributions

All authors contributed to the study conception and design. Patient allocation, data collection and analysis were performed by EG and SG. The first draft of the manuscript was written by EG and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

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Correspondence to Eman Ghonaim.

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The study protocol was approved by the Research Ethics Committee of Tanta University and was carried out in compliance with the Declaration of Helsinki.

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Ghonaim, E., El-Haggar, S. & Gohar, S. Possible protective effect of pantoprazole against cisplatin-induced nephrotoxicity in head and neck cancer patients: a randomized controlled trial. Med Oncol 38, 108 (2021). https://doi.org/10.1007/s12032-021-01558-y

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