Department of Medicine, Beth Israel Medical Center, University Hospital and Manhattan Campus for the Albert Einstein College of Medicine, New York, United States.
Crit Rev Oncol Hematol. 2013 Oct;88(1):30-41. doi: 10.1016/j.critrevonc.2013.06.001. Epub 2013 Jul 5.
We performed a systematic review and meta-analysis of hematologic toxicities associated with everolimus, an oral mammalian target of rapamycin (mTOR) inhibitor. Eligible studies included phase II and III trials of patients with solid tumors on 10mg of everolimus daily describing events of neutropenia, thrombocytopenia, anemia or lymphopenia. The incidence of everolimus-associated all-grade and high-grade (Grade 3-4) hematologic toxicities were, respectively: neutropenia: 21.7% and 3.6%; thrombocytopenia: 36.0% and 4.7%; anemia: 61.2% and 8.4% and lymphopenia: 40.9% and 14.9%. Everolimus was associated with an increased risk of all-grade neutropenia (RR=2.24, [95% CI 1.51-3.32]), all-grade (RR=9.19, [95% CI 4.51-18.70]) and high-grade (RR=7.46, [95% CI 2.58-21.61]) thrombocytopenia, all-grade (RR=1.58, [95% CI 1.25-1.99]) and high-grade (RR=3.92, [95% CI 1.46-10.52]) anemia and all-grade (RR=1.72, [95% CI 1.50-1.97]) and high-grade (RR=2.70, [95% CI 1.86-3.93]) lymphopenia.
我们对依维莫司（一种口服哺乳动物雷帕霉素靶蛋白（mTOR）抑制剂）相关血液学毒性进行了系统评价和荟萃分析。纳入的研究包括 10mg 依维莫司每日治疗的实体瘤患者的 II 期和 III 期试验，描述了中性粒细胞减少症、血小板减少症、贫血或淋巴细胞减少症的事件。依维莫司相关的所有级别和高级别（3-4 级）血液学毒性的发生率分别为：中性粒细胞减少症：21.7%和 3.6%；血小板减少症：36.0%和 4.7%；贫血：61.2%和 8.4%；淋巴细胞减少症：40.9%和 14.9%。依维莫司与所有级别中性粒细胞减少症（RR=2.24，[95%CI 1.51-3.32]）、所有级别（RR=9.19，[95%CI 4.51-18.70]）和高级别（RR=7.46，[95%CI 2.58-21.61]）血小板减少症、所有级别（RR=1.58，[95%CI 1.25-1.99]）和高级别（RR=3.92，[95%CI 1.46-10.52]）贫血以及所有级别（RR=1.72，[95%CI 1.50-1.97]）和高级别（RR=2.70，[95%CI 1.86-3.93]）淋巴细胞减少症相关风险增加。
