Division of Medical Oncology/Hematology, The Moncton Hospital, Moncton, NB. ; Department of Medicine, Dalhousie University, Halifax, NS.
Division of Medical Oncology/Hematology, The Moncton Hospital, Moncton, NB. ; Department of Medicine, Memorial University, St. John's, NL.
Curr Oncol. 2014 Oct;21(5):e732-5. doi: 10.3747/co.21.2038.
The introduction of targeted agents has improved survival for patients with a number of types of cancer, including several breast cancer subtypes. However, these agents are not without toxicities, and the fact that many patients are now on targeted therapy for extended periods of time has presented new challenges for the management of adverse effects. Everolimus is an inhibitor of mtor (the mammalian target of rapamycin) that is used as targeted therapy for advanced, hormone receptor-positive, her2-negative breast cancer in postmenopausal women in combination with exemestane, after treatment failure with letrozole or anastrozole. Minor hemorrhagic events are relatively common with targeted agents, but life-threatening hemorrhages, although uncommon, can also occur. We report a case of life-threatening gastrointestinal bleeding in a 48-year-old woman being treated with everolimus for advanced infiltrating ductal carcinoma of the breast. The bleeding was successfully treated with 13 sessions of endoscopic hemostasis using argon plasma coagulation.
靶向药物的引入改善了多种类型癌症患者的生存状况，包括几种乳腺癌亚型。然而，这些药物并非没有毒性，而且许多患者现在需要长期接受靶向治疗，这给不良反应的管理带来了新的挑战。依维莫司是一种 mtor 抑制剂（哺乳动物雷帕霉素靶蛋白），与依西美坦联合用于绝经后妇女激素受体阳性、HER2 阴性晚期乳腺癌的靶向治疗，在来曲唑或阿那曲唑治疗失败后使用。靶向药物治疗时，轻微的出血事件较为常见，但危及生命的出血虽然不常见，但也可能发生。我们报告了一例 48 岁女性因晚期浸润性导管癌接受依维莫司治疗而发生危及生命的胃肠道出血的病例。使用氩等离子凝固术进行了 13 次内镜止血治疗，成功止血。
