Sonis Stephen T
Brigham and Women's Hospital and the Dana-Farber Cancer Institute, Boston, MA, USA.
Core Evid. 2010 Jun 15;4:199-205. doi: 10.2147/ce.s5995.
Oral mucositis is a significant toxicity of cytotoxic chemo- and radiation-therapy used to treat cancer. Palifermin is the first pharmaceutical/biological agent approved for the intervention of oral mucositis. The major objective of this review is to evaluate the evidence supporting the use of palifermin.
A literature search was performed using an appropriate keyword search in MEDLINE and PubMed databases.
Of 100 full papers and 4 abstracts identified, 12 papers and 3 abstracts were appropriate for analysis. Level 2 evidence supporting palifermin use in patients with hematologic malignancies being treated with autologous hematopoietic stem cell transplantation (HSCT) is clear. Level 2 evidence also exists for the use of palifermin in the prevention of oral mucositis in patients with solid tumors (colorectal cancer, head and neck cancer), but is incomplete. Level >/= 3 data support the use of palifermin in allogeneic HSCT recipients and cycled chemotherapy. A single health economic study concluded that palifermin is essentially cost neutral in the autologous HSCT population.
Data supporting the use of palifermin in autologous HSCT recipients with hematologic malignancies is clear. Some data exist demonstrating its efficacy in other oncologic indications. Additional studies are needed to broaden the potential applications of palifermin and to ascertain its economic, but not symptomatic, effectiveness.
口腔黏膜炎是用于治疗癌症的细胞毒性化疗和放射治疗的一种严重毒性反应。帕利夫明是首个被批准用于干预口腔黏膜炎的药物/生物制剂。本综述的主要目的是评估支持使用帕利夫明的证据。
在MEDLINE和PubMed数据库中使用适当的关键词进行文献检索。
在检索到的100篇全文和4篇摘要中，有12篇论文和3篇摘要适合进行分析。有明确的二级证据支持帕利夫明用于接受自体造血干细胞移植（HSCT）治疗的血液系统恶性肿瘤患者。也有二级证据表明帕利夫明可用于预防实体瘤（结直肠癌、头颈癌）患者的口腔黏膜炎，但证据不完整。≥3级的数据支持帕利夫明用于异基因HSCT受者和周期化疗。一项卫生经济学研究得出结论，在自体HSCT人群中，帕利夫明基本不影响成本。
支持帕利夫明用于血液系统恶性肿瘤自体HSCT受者的数据很明确。有一些数据表明其在其他肿瘤适应症中的疗效。需要进一步的研究来扩大帕利夫明的潜在应用范围，并确定其经济而非症状方面的有效性。
