Lung Cancer:EGFR酪氨酸激酶抑制剂用于EGFR阳性突变的非小细胞肺癌的安全性分析

2015-02-28 范伟译 MedSci原创

目的:三个表皮生长因子受体(EGFR)酪氨酸激酶抑制剂(TKIs)- 阿法替尼,厄洛替尼,和吉非替尼用于EGFR阳性突变的非小细胞肺癌(NSCLC)患者的治疗。由于患者长期接触表皮生长因子受体酪氨酸激酶抑制剂,这些药物对这些人产生的毒理学性质可能不同于那些未长期接触的患者。我们对这三个表皮生长因子受体酪氨酸激酶抑制剂治疗EGFR阳性突变的NSCLC患者发生严重不良反应的频率(AES)进行比较。

目的:三个表皮生长因子受体(EGFR)酪氨酸激酶抑制剂(TKIs)- 阿法替尼,厄洛替尼,和吉非替尼用于EGFR阳性突变的非小细胞肺癌(NSCLC)患者的治疗。由于患者长期接触表皮生长因子受体酪氨酸激酶抑制剂,这些药物对这些人产生的毒理学性质可能不同于那些未长期接触的患者。我们对这三个表皮生长因子受体酪氨酸激酶抑制剂治疗EGFR阳性突变的NSCLC患者发生严重不良反应的频率(AES)进行比较。

材料和方法:从目前前瞻性临床试验中把EGFR酪氨酸激酶抑制剂的使用数据提取出来,我们进行了一项严重不良反应的汇总分析,评估吉非替尼,厄洛替尼,阿法替尼在EGFR突变的NSCLC患者中的临床疗效。

结果:21项发表于2006-2014年间涉及1468例患者的临床试验纳入分析中。13项临床试验的患者(n = 457)接受吉非替尼治疗,5项临床试验的患者(n = 513)接受厄洛替尼,3项临床试验的患者(n = 498)接受阿法替尼。阿法替尼治疗发生大于或等于3级皮疹和腹泻的副反应明显比厄洛替尼或吉非替尼治疗更频繁。三个表皮生长因子受体酪氨酸激酶抑制剂发生大于或等于3级间质性肺疾病(ILD)的频率较低(0.6-2.2 %),且三者没有显著的不同。吉非替尼相比于厄洛替尼或阿法替尼,与大于或等于3级的高频率肝毒性相关。导致停药的严重不良反应的总频率为6.1%(1354例接受评估的患者中的83人),接受阿法替尼或吉非替尼治疗相比于厄洛替尼治疗时,这些不良反应的发生明显更频繁。最常见的导致停药的不良反应有皮肤毒性,间质性肺疾病和肝毒性。

结论:不良反应的这些信息促使EGFR阳性突变的非小细胞肺癌患者就某些类型毒性的风险缓解选择最合适的EGFR酪氨酸激酶抑制剂。

原始出处

Takeda M, Okamoto I, Nakagawa K. Pooled safety analysis of EGFR-TKI treatment for EGFR mutation-positive non-small cell lung cancer.Lung Cancer. 2015 Feb 7. pii: S0169-5002(15)00091-4. doi: 10.1016/j.lungcan.2015.01.026.

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    2015-05-16 ljjj1053

    很不错学习了

    0

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    2015-09-03 jklm09
  6. [GetPortalCommentsPageByObjectIdResponse(id=1740624, encodeId=3d011e40624bd, content=<a href='/topic/show?id=fd0a95511dd' target=_blank style='color:#2F92EE;'>#酪氨酸激酶#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=95511, encryptionId=fd0a95511dd, topicName=酪氨酸激酶)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=22af34798690, createdName=luckyshitiancai_42705695, createdTime=Wed May 13 21:47:00 CST 2015, time=2015-05-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2039857, encodeId=9b5f203985e6c, content=<a href='/topic/show?id=f7526685963' target=_blank style='color:#2F92EE;'>#激酶抑制剂#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=66859, encryptionId=f7526685963, topicName=激酶抑制剂)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e76f39, createdName=smartjoy, createdTime=Thu Jan 14 03:47:00 CST 2016, time=2016-01-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2082082, encodeId=e4212082082b3, content=<a href='/topic/show?id=27b2660581' target=_blank style='color:#2F92EE;'>#EGFR阳性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=6605, encryptionId=27b2660581, topicName=EGFR阳性)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTKnILSXam1GxPwj04ylEzibYLFA2eGl5Ev02klt80JA0xejMPqrn0mYHNNnLEgyqYTPbicXpY3tn6SA/132, createdBy=38fd2500059, createdName=新生儿张玉军, createdTime=Sat Oct 10 10:47:00 CST 2015, time=2015-10-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=23729, encodeId=770223e299a, content=很不错学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=106, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=/v1.0.0/img/user_icon.png, createdBy=ac181616815, createdName=ljjj1053, createdTime=Sat May 16 19:51:00 CST 2015, time=2015-05-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1851231, encodeId=66c61851231ea, content=<a href='/topic/show?id=f0a254918f0' target=_blank style='color:#2F92EE;'>#抑制剂#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=17, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=54918, encryptionId=f0a254918f0, topicName=抑制剂)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=44a360, createdName=jklm09, createdTime=Thu Sep 03 07:47:00 CST 2015, time=2015-09-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2059495, encodeId=1d2a205949530, content=<a href='/topic/show?id=2cc599381bd' target=_blank style='color:#2F92EE;'>#非小细胞#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=99381, encryptionId=2cc599381bd, topicName=非小细胞)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a12645, createdName=智智灵药, createdTime=Sun May 10 05:47:00 CST 2015, time=2015-05-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=17397, encodeId=c5b41e397ac, content=好文章,超赞, beContent=null, objectType=article, channel=null, level=null, likeNumber=105, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=36a81612921, createdName=xiaoai5777, createdTime=Mon Mar 02 21:19:00 CST 2015, time=2015-03-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1495933, encodeId=b66d149593387, content=<a href='/topic/show?id=9c516685eea' target=_blank style='color:#2F92EE;'>#激酶#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=66857, encryptionId=9c516685eea, topicName=激酶)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=73449239400, createdName=redcrab, createdTime=Mon Mar 02 01:47:00 CST 2015, time=2015-03-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1534266, encodeId=01a615342667a, content=<a href='/topic/show?id=22b3e9887e' target=_blank style='color:#2F92EE;'>#GFR#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7988, encryptionId=22b3e9887e, topicName=GFR)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0a812532020, createdName=liuyiping, createdTime=Mon Mar 02 01:47:00 CST 2015, time=2015-03-02, status=1, ipAttribution=)]
  7. [GetPortalCommentsPageByObjectIdResponse(id=1740624, encodeId=3d011e40624bd, content=<a href='/topic/show?id=fd0a95511dd' target=_blank style='color:#2F92EE;'>#酪氨酸激酶#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=95511, encryptionId=fd0a95511dd, topicName=酪氨酸激酶)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=22af34798690, createdName=luckyshitiancai_42705695, createdTime=Wed May 13 21:47:00 CST 2015, time=2015-05-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2039857, encodeId=9b5f203985e6c, content=<a href='/topic/show?id=f7526685963' target=_blank style='color:#2F92EE;'>#激酶抑制剂#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=66859, encryptionId=f7526685963, topicName=激酶抑制剂)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e76f39, createdName=smartjoy, createdTime=Thu Jan 14 03:47:00 CST 2016, time=2016-01-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2082082, encodeId=e4212082082b3, content=<a href='/topic/show?id=27b2660581' target=_blank style='color:#2F92EE;'>#EGFR阳性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=6605, encryptionId=27b2660581, topicName=EGFR阳性)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTKnILSXam1GxPwj04ylEzibYLFA2eGl5Ev02klt80JA0xejMPqrn0mYHNNnLEgyqYTPbicXpY3tn6SA/132, createdBy=38fd2500059, createdName=新生儿张玉军, createdTime=Sat Oct 10 10:47:00 CST 2015, time=2015-10-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=23729, encodeId=770223e299a, content=很不错学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=106, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=/v1.0.0/img/user_icon.png, createdBy=ac181616815, createdName=ljjj1053, createdTime=Sat May 16 19:51:00 CST 2015, time=2015-05-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1851231, encodeId=66c61851231ea, content=<a href='/topic/show?id=f0a254918f0' target=_blank style='color:#2F92EE;'>#抑制剂#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=17, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=54918, encryptionId=f0a254918f0, topicName=抑制剂)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=44a360, createdName=jklm09, createdTime=Thu Sep 03 07:47:00 CST 2015, time=2015-09-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2059495, encodeId=1d2a205949530, content=<a href='/topic/show?id=2cc599381bd' target=_blank style='color:#2F92EE;'>#非小细胞#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=99381, encryptionId=2cc599381bd, topicName=非小细胞)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a12645, createdName=智智灵药, createdTime=Sun May 10 05:47:00 CST 2015, time=2015-05-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=17397, encodeId=c5b41e397ac, content=好文章,超赞, beContent=null, objectType=article, channel=null, level=null, likeNumber=105, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=36a81612921, createdName=xiaoai5777, createdTime=Mon Mar 02 21:19:00 CST 2015, time=2015-03-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1495933, encodeId=b66d149593387, content=<a href='/topic/show?id=9c516685eea' target=_blank style='color:#2F92EE;'>#激酶#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=66857, encryptionId=9c516685eea, topicName=激酶)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=73449239400, createdName=redcrab, createdTime=Mon Mar 02 01:47:00 CST 2015, time=2015-03-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1534266, encodeId=01a615342667a, content=<a href='/topic/show?id=22b3e9887e' target=_blank style='color:#2F92EE;'>#GFR#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7988, encryptionId=22b3e9887e, topicName=GFR)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0a812532020, createdName=liuyiping, createdTime=Mon Mar 02 01:47:00 CST 2015, time=2015-03-02, status=1, ipAttribution=)]
    2015-03-02 xiaoai5777

    好文章,超赞

    0

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    2015-03-02 redcrab
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    2015-03-02 liuyiping