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Cystatins

Urinary and blood samples for cystatin C dosage

Urinary and blood cystatin C are sampled in patient with nephrotoxic risks before the treatment beginning, after the first course of chemotherapy, in the middle and at the end of the treatment. A follow up assessment is also required at 2 and 5 years. The cystatin C measurements are compared to traditional nephrology markers. Their sampling requires additional blood and urinary collection but involve minimal risks for patient.

Urinary and blood sample for Cystatine dosage

Marlène Pasquet

Cisplatin and ifosfamide are commonly used drugs in chemotherapy. They are known to involve renal toxic threats in children given their immature kidney. This toxicity is increased especially after nephrectomy and/or concomitant radiotherapy. In pediatric oncology, the available evaluation methods of the renal function could be very restrictive to perform on children. In this study, the investigators intend to test the use of the cystatin C as an effective and reliable biological marker of renal toxicity in children treated with cisplatin and / or ifosfamide.

Cisplatin and ifosfamide are commonly used drugs in chemotherapy. They are known to involve renal toxic threats in children given their immature kidney. This toxicity is increased especially after nephrectomy and/or concomitant radiotherapy. In pediatric oncology, the evaluation of the renal function is carried out according to the clinical trial protocols and to the center practices. To date, the standard methods (eg. creatinine clearance), as well as the available predictive formula (eg. Schwartz formula) are not well adapted to monitor children renal function. Indeed, the reliability of these methods depends on several parameters such as the diet and the muscle mass and could be very restrictive to perform on children. To circumvent these practical difficulties, the investigators intend to use the cystatin C as a biological marker of renal toxicity in children treated with cisplatin and / or ifosfamide. This cysteine protease has witnessed an upsurge of interest as an endogenous glomerular filtration rate marker and could be a good candidate to assess tubular toxicity when measured in urine.

This study aims to describe the kinetic of the appearance of the urinary cystatin C and explore its proprieties as an early and cost-effective marker for glomerular and tubular renal toxicity in children. In addition, this method could allow enhancing the calculation models routinely used for glomerular filtration rate.

Description of the Cystatin C as an Early Nephrotoxic Bio-marker in Pediatric Oncology

Assessment of Cystatin C as a Tubular and Glomerular Marker of Nephrotoxicity in Pediatric Oncology

at T2a and T2b (at the middle of treatment). It can depend on pathology

at T3 (at the end of treatment)It can depend on pathology

CysC is positive when it is detectable in urine, i.e when one or more reference biomarkers are positive

Study title	NCT ID	Conditions	Interventions	Eligibility	Organization
Description of the Cystatin C as an Early Nephrotoxic Bio-marker in Pediatric Oncology	NCT02822404	Kidney Diseases	Urinary and blo...	- 18 Years	University Hospital, Toulouse
Description of the Cystatin C as an Early Nephrotoxic Bio-marker in Pediatric Oncology	NCT02822404	Kidney Diseases	Urinary and blo...	- 18 Years	University Hospital, Toulouse
Description of the Cystatin C as an Early Nephrotoxic Bio-marker in Pediatric Oncology	NCT02822404	Kidney Diseases	Urinary and blo...	- 18 Years	University Hospital, Toulouse

Spots Global Cancer Trial Database for kidney toxicity