Centro Integral Oncologico Clara Campal, Madrid, Spain.
Anticancer Drugs. 2010 Jun;21(5):478-86. doi: 10.1097/cad.0b013e32833760bf.
The inhibitors of the mammalian target of rapamycin (mTOR) improve outcomes in patients with advanced renal cell carcinoma. These agents are associated with unusual class-adverse events that represent a challenge to the clinician, making it critical to recognize and treat them appropriately. This study aims to highlight the clinical management of these toxicities by presenting evidence from the literature and suggesting treatment recommendations. A critical review of the literature is performed and a summary of the most relevant emergent toxicities and their management is presented. Treatment recommendations of metabolic disturbances induced by mTOR inhibitors, such as hypophosphatemia, hyperglycemia, and hyperlipidemia along with the management of drug-induced pneumonitis and possible pharmacological interactions are presented. Most of these toxicities, if recognized and treated accordingly, should resolve with minimal impact on patients' quality of life and in the efficacy of this anticancer therapy. Oncologists should be familiar with the recognition and appropriate medical management of these clinical scenarios.
哺乳动物雷帕霉素靶蛋白（mTOR）抑制剂可改善晚期肾细胞癌患者的预后。这些药物与不常见的类别不良事件相关，这对临床医生构成了挑战，因此正确识别和治疗这些不良事件至关重要。本研究旨在通过从文献中提供证据并提出治疗建议，强调这些毒性的临床管理。对文献进行了批判性回顾，并总结了最相关的紧急毒性及其管理。提出了 mTOR 抑制剂引起的代谢紊乱（如低磷血症、高血糖和高血脂）的治疗建议，以及药物性肺炎的管理和可能的药物相互作用。如果识别并相应地进行治疗，大多数这些毒性反应应该会得到解决，对患者的生活质量和这种抗癌疗法的疗效的影响最小。肿瘤学家应该熟悉这些临床情况的识别和适当的医学管理。
