Stansfield Lindsay C, Gonsalves Wilson I, Buadi Francis K
Department of Pharmacy, Denver Health, Denver, CO 80204, USA.
Future Oncol. 2015;11(3):501-10. doi: 10.2217/fon.14.270.
Novel drugs such as immunomodulators and proteasome inhibitors have improved the survival of patients with multiple myeloma. Like all therapeutic agents, appropriate dosing based on metabolism and clearance is important to maintain efficacy while avoiding toxicity. Hepatic impairment (HI) in multiple myeloma patients is rare but well described either due to disease or therapy-related factors. However, limited data are available on the appropriate use and dosing of the novel agent therapeutics in myeloma patients with HI. Furthermore, data on HI secondary to the novel agent toxicity are also sparse. This systematic review highlights the evidence on the use of novel agents like thalidomide, lenalidomide, pomalidomide, bortezomib and carfilzomib in patients with HI as well as their associated hepatic toxicities.
免疫调节剂和蛋白酶体抑制剂等新型药物提高了多发性骨髓瘤患者的生存率。与所有治疗药物一样，根据代谢和清除情况进行适当给药对于维持疗效同时避免毒性至关重要。多发性骨髓瘤患者的肝损伤（HI）很少见，但因疾病或治疗相关因素已有充分描述。然而，关于HI的骨髓瘤患者使用新型药物治疗的适当方法和剂量的数据有限。此外，关于新型药物毒性继发的HI的数据也很少。本系统综述强调了沙利度胺、来那度胺、泊马度胺、硼替佐米和卡非佐米等新型药物在HI患者中的使用证据及其相关肝毒性。
