Tang Nikki, Ratner Desiree
*Department of Dermatology, Mount Sinai St. Luke's-Roosevelt, New York, New York; †Department of Dermatology, Mount Sinai Beth Israel, Hospital Center, New York, New York.
Dermatol Surg. 2016 Jan;42 Suppl 1:S40-8. doi: 10.1097/DSS.0000000000000519.
Targeted anticancer therapies can cause cutaneous adverse events different from classical chemotherapeutic toxicities.
To review the literature on dermatologic adverse events (DAEs) of targeted molecular inhibitors for melanoma and nonmelanoma skin cancers with a focus on management options.
A comprehensive literature search related to the side effects and management of these side effects from vemurafenib, dabrafenib, trametinib (BRAF inhibitors), pembrolizumab (antiprogrammed-death-receptor-1 antibody), imatinib (tyrosine kinase inhibitor), ipilimumab (anticytotoxic T-lymphocyte antigen-4 antibody), cetuximab (epidermal growth factor receptor inhibitor), sorafenib (multikinase inhibitor), and vismodegib (smoothened receptor inhibitor).
No large controlled studies specifically examining the management of DAEs of targeted molecular inhibitors exist, although there are case report-based recommendations and algorithms developed by expert panels to manage these adverse events.
Many options for managing the cutaneous side effects of targeted molecular inhibitors are similar to those used in general dermatology practice. When used effectively, drug dosing and patient quality of life may be optimized.
靶向抗癌疗法可引发与传统化疗毒性不同的皮肤不良事件。
综述关于黑色素瘤和非黑色素瘤皮肤癌靶向分子抑制剂的皮肤不良事件(DAE)的文献,重点关注管理方案。
全面检索有关维莫非尼、达拉非尼、曲美替尼(BRAF抑制剂)、帕博利珠单抗(抗程序性死亡受体-1抗体)、伊马替尼(酪氨酸激酶抑制剂)、伊匹木单抗(抗细胞毒性T淋巴细胞抗原-4抗体)、西妥昔单抗(表皮生长因子受体抑制剂)、索拉非尼(多激酶抑制剂)和维莫德吉( smoothened受体抑制剂)的副作用及这些副作用管理的文献。
虽然有基于病例报告的建议以及专家小组制定的管理这些不良事件的算法,但尚无专门研究靶向分子抑制剂皮肤不良事件管理的大型对照研究。
管理靶向分子抑制剂皮肤副作用的许多方案与一般皮肤科实践中使用的方案相似。若有效使用,可优化药物剂量和患者生活质量。