靶向癌症治疗患者的瘙痒：系统评价和荟萃分析。
Pruritus in patients treated with targeted cancer therapies: systematic review and meta-analysis.
机构信息
Dermatology Service, Department of Medicine, Memorial Sloan-Kettering Cancer Center, New York, New York.
Division of Medical Oncology, Department of Medicine, State University of New York at Stony Brook, Stony Brook, New York.
出版信息
J Am Acad Dermatol. 2013 Nov;69(5):708-720. doi: 10.1016/j.jaad.2013.06.038. Epub 2013 Aug 24.
BACKGROUND
Pruritus has been anecdotally described in association with targeted cancer therapies. The risk of pruritus has not been systematically ascertained.
OBJECTIVE
A systematic review and meta-analysis of the literature was conducted for axitinib, cetuximab, dasatinib, erlotinib, everolimus, gefitinib, imatinib, ipilimumab, lapatinib, nilotinib, panitumumab, pazopanib, rituximab, sorafenib, temsirolimus, tositumomab, vandetanib, and vemurafenib.
METHODS
Databases from PubMed, Web of Science (January 1998 through July 2012), and American Society of Clinical Oncology abstracts (2004 through 2012) were searched. Incidence and relative risk of pruritus were calculated using random- or fixed-effects model.
RESULTS
The incidences of all-grade and high-grade pruritus were 17.4% (95% confidence interval 16.0%-19.0%) and 1.4% (95% confidence interval 1.2%-1.6%), respectively. There was an increased risk of all-grade pruritus (relative risk 2.90 [95% confidence interval 1.76-4.77, P < .001]) and variation among different drugs (P < .001).
LIMITATIONS
The reporting of pruritus may vary, resulting from concomitant medications, comorbidities, and underlying malignancies. We found a higher incidence of pruritus in patients with solid tumors, concordant with those targeted therapies with the highest pruritus incidences.
CONCLUSION
There is a significant risk of developing pruritus in patients receiving targeted therapies. To prevent suboptimal dosing and decreased quality of life, patients should be counseled and treated against this untoward symptom.
背景
瘙痒已被描述为与靶向癌症治疗相关的一种偶发症状。但瘙痒的风险尚未被系统地确定。
目的
对阿西替尼、西妥昔单抗、达沙替尼、厄洛替尼、依维莫司、吉非替尼、伊马替尼、依匹单抗、拉帕替尼、尼洛替尼、帕尼单抗、帕唑帕尼、利妥昔单抗、索拉非尼、替西罗莫司、托西莫单抗、凡德他尼和维莫非尼等药物进行了文献的系统评价和荟萃分析。
方法
检索了 PubMed、Web of Science（1998 年 1 月至 2012 年 7 月）和美国临床肿瘤学会摘要（2004 年至 2012 年）数据库。采用随机或固定效应模型计算瘙痒的发生率和相对风险。
结果
所有等级和高等级瘙痒的发生率分别为 17.4%（95%置信区间 16.0%-19.0%）和 1.4%（95%置信区间 1.2%-1.6%）。所有等级瘙痒的风险增加（相对风险 2.90[95%置信区间 1.76-4.77，P<.001]）和不同药物之间的差异（P<.001）。
局限性
瘙痒的报告可能因伴随的药物、合并症和潜在的恶性肿瘤而有所不同。我们发现，接受靶向治疗的实体瘤患者瘙痒发生率较高，这与瘙痒发生率最高的靶向治疗药物一致。
结论
接受靶向治疗的患者发生瘙痒的风险显著增加。为了防止剂量不足和生活质量下降，应对患者进行咨询并针对这种不良症状进行治疗。
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