甲吡酮：静脉注射依托泊苷治疗小细胞肺癌异位促肾上腺皮质激素综合征的一种治疗选择。

Metyrapone: a management option for ectopic ACTH syndrome in small cell lung cancer treated with intravenous etoposide.

作者信息

Aziz Shaikh Irfan, Khattak Muhammad Adnan, Usmani Zafar, Ladipeerla Narsing, Pittman Ken

机构信息

Department of Endocrinology, The Queen Elizabeth Hospital, Adelaide, Australia.

出版信息

BMJ Case Rep. 2011 Aug 4;2011:bcr0420102917. doi: 10.1136/bcr.04.2010.2917.

DOI:10.1136/bcr.04.2010.2917

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC4545102/

Abstract

Small cell lung cancer (SCLC) with ectopic adrenocorticotropic hormone (ACTH) syndrome and resultant hypercortisolism carries a poor prognosis with a short median survival and high incidence of infective complications. The combination of etoposide with either carboplatin or cisplatin is the current standard chemotherapy used for the management of SCLC. Etoposide is metabolised by cytochrome P450 3A4. Ketoconazole is an imidazole derivative possessing antifungal properties and also causes inhibition of adrenal corticosteroid and androgen production. There is an additional increased risk of toxicity due to a potential interaction between etoposide and ketoconazole, which is a strong inhibitor of cytochrome P450 3A4, and theoretically can lead to greater myelosuppression. Metyrapone can be a safe alternative in such settings.

摘要

伴有异位促肾上腺皮质激素（ACTH）综合征及由此导致的皮质醇增多症的小细胞肺癌（SCLC）预后较差，中位生存期短，感染并发症发生率高。依托泊苷联合卡铂或顺铂是目前用于治疗SCLC的标准化疗方案。依托泊苷由细胞色素P450 3A4代谢。酮康唑是一种具有抗真菌特性的咪唑衍生物，还可抑制肾上腺皮质类固醇和雄激素的生成。依托泊苷与酮康唑之间可能存在相互作用，酮康唑是细胞色素P450 3A4的强效抑制剂，理论上可导致更强的骨髓抑制，从而使毒性风险进一步增加。在这种情况下，甲吡酮可能是一种安全的替代药物。

相似文献

1

Metyrapone: a management option for ectopic ACTH syndrome in small cell lung cancer treated with intravenous etoposide.甲吡酮：静脉注射依托泊苷治疗小细胞肺癌异位促肾上腺皮质激素综合征的一种治疗选择。

BMJ Case Rep. 2011 Aug 4;2011:bcr0420102917. doi: 10.1136/bcr.04.2010.2917.

2

Syndrome of inappropriate antidiuretic hormone secretion and ectopic ACTH production in small cell lung carcinoma.小细胞肺癌中的抗利尿激素分泌不当综合征和异位促肾上腺皮质激素分泌

Lung Cancer. 2007 Jul;57(1):120-2. doi: 10.1016/j.lungcan.2007.03.003. Epub 2007 Apr 5.

3

Spontaneous adrenocorticotropic hormone (ACTH) normalisation due to tumour regression induced by metyrapone in a patient with ectopic ACTH syndrome: case report and literature review.甲吡酮诱导肿瘤消退导致异位促肾上腺皮质激素（ACTH）综合征患者的促肾上腺皮质激素（ACTH）自发恢复正常：病例报告及文献综述

BMC Endocr Disord. 2018 Mar 27;18(1):19. doi: 10.1186/s12902-018-0246-2.

4

Marked increase in plasma ACTH with tumor reduction after chemotherapy in ectopic ACTH syndrome.

Endocr J. 1999 Apr;46(2):331-5. doi: 10.1507/endocrj.46.331.

5

Durvalumab plus platinum-etoposide versus platinum-etoposide in first-line treatment of extensive-stage small-cell lung cancer (CASPIAN): a randomised, controlled, open-label, phase 3 trial.度伐利尤单抗联合铂类依托泊苷与铂类依托泊苷一线治疗广泛期小细胞肺癌（CASPIAN）：一项随机、对照、开放标签、III 期临床试验。

Lancet. 2019 Nov 23;394(10212):1929-1939. doi: 10.1016/S0140-6736(19)32222-6. Epub 2019 Oct 4.

6

[Small cell lung cancer with Sézary syndrome].小细胞肺癌伴Sezary综合征

Nihon Kokyuki Gakkai Zasshi. 2009 Dec;47(12):1135-40.

7

The feasibility study of Carboplatin plus Etoposide for advanced small cell lung cancer with idiopathic interstitial pneumonias.卡铂联合依托泊苷治疗特发性间质性肺炎相关的晚期小细胞肺癌的可行性研究。

J Thorac Oncol. 2011 Apr;6(4):801-7. doi: 10.1097/JTO.0b013e3182103d3c.

8

Cushing's syndrome associated with ectopic corticotropin production and small-cell lung cancer.与异位促肾上腺皮质激素分泌及小细胞肺癌相关的库欣综合征

J Clin Oncol. 1992 Jan;10(1):21-7. doi: 10.1200/JCO.1992.10.1.21.

9

Five-day oral etoposide treatment for advanced small-cell lung cancer: randomized comparison with intravenous chemotherapy.口服依托泊苷五日疗法治疗晚期小细胞肺癌：与静脉化疗的随机对照研究

J Natl Cancer Inst. 1997 Apr 16;89(8):577-80. doi: 10.1093/jnci/89.8.577.

10

Paclitaxel as third-line chemotherapy for small cell lung cancer failing both etoposide- and camptothecin-based chemotherapy.紫杉醇作为依托泊苷和喜树碱为基础的化疗均失败后的小细胞肺癌三线化疗药物。

Medicine (Baltimore). 2017 Oct;96(42):e8176. doi: 10.1097/MD.0000000000008176.

引用本文的文献

1

Refractory postoperative Staphylococcus hominis bacteremia in a patient with an ACTH-producing pancreatic neuroendocrine neoplasm: a case report.一例分泌促肾上腺皮质激素的胰腺神经内分泌肿瘤患者术后难治性人葡萄球菌菌血症：病例报告

Surg Case Rep. 2022 Jun 29;8(1):126. doi: 10.1186/s40792-022-01485-8.

2

Beyond the Dual Paraneoplastic Syndromes of Small-Cell Lung Cancer with ADH and ACTH Secretion: A Case Report with Literature Review and Future Implications.小细胞肺癌伴抗利尿激素和促肾上腺皮质激素分泌的双重副肿瘤综合征之外：一例报告并文献综述及未来意义

Case Rep Oncol Med. 2018 Oct 18;2018:4038397. doi: 10.1155/2018/4038397. eCollection 2018.

3

Comparison of tumor related signaling pathways with known compounds to determine potential agents for lung adenocarcinoma.比较肿瘤相关信号通路与已知化合物，以确定用于肺腺癌的潜在药物。

Thorac Cancer. 2018 Aug;9(8):974-988. doi: 10.1111/1759-7714.12773. Epub 2018 Jun 5.

本文引用的文献

1

Pharmacokinetic modulation of oral etoposide by ketoconazole in patients with advanced cancer.酮康唑对晚期癌症患者口服依托泊苷的药代动力学调节作用。

Cancer Chemother Pharmacol. 2007 Nov;60(6):811-9. doi: 10.1007/s00280-007-0428-5. Epub 2007 Feb 17.

2

A study on the metabolism of etoposide and possible interactions with antitumor or supporting agents by human liver microsomes.依托泊苷的代谢及与人类肝微粒体中抗肿瘤或支持性药物可能的相互作用的研究。

J Pharmacol Exp Ther. 1998 Sep;286(3):1294-300.

3

Ectopic corticotropin syndrome and small-cell carcinoma of the lung. Clinical features, outcome, and complications.异位促肾上腺皮质激素综合征与肺小细胞癌。临床特征、转归及并发症。

Arch Intern Med. 1993 Mar 22;153(6):746-52.

4

Endocrine function in small cell undifferentiated carcinoma of the lung.

Cancer. 1982 Nov 15;50(10):2147-53. doi: 10.1002/1097-0142(19821115)50:10<2147::aid-cncr2820501029>3.0.co;2-m.

5

Hormonal polypeptides and amine metabolites in small cell carcinoma of the lung, with special reference to stage and subtypes.

Cancer. 1980 Mar 15;45(6):1432-7. doi: 10.1002/1097-0142(19800315)45:6<1432::aid-cncr2820450622>3.0.co;2-z.

6

Ketoconazole. Use in the treatment of ectopic adrenocorticotropic hormone production and Cushing's syndrome in small-cell lung cancer.

Arch Intern Med. 1985 May;145(5):863-4. doi: 10.1001/archinte.145.5.863.

7

Alteration of etoposide pharmacokinetics and pharmacodynamics by cyclosporine in a phase I trial to modulate multidrug resistance.

J Clin Oncol. 1992 Oct;10(10):1635-42. doi: 10.1200/JCO.1992.10.10.1635.

8

Cushing's syndrome associated with ectopic corticotropin production and small-cell lung cancer.与异位促肾上腺皮质激素分泌及小细胞肺癌相关的库欣综合征

J Clin Oncol. 1992 Jan;10(1):21-7. doi: 10.1200/JCO.1992.10.1.21.

文献AI研究员

20分钟写一篇综述，助力文献阅读效率提升50倍。

用中文搜PubMed

大模型驱动的PubMed中文搜索引擎

文档翻译

学术文献翻译模型，支持多种主流文档格式。