Lew Sungyub, Chamberlain Ronald S
Department of Surgery, Saint Barnabas Medical Center, Livingston, NJ, U.S.A. Saint George's University School of Medicine, St. George, Grenada, West Indies.
Department of Surgery, Saint Barnabas Medical Center, Livingston, NJ, U.S.A. Department of Surgery, New Jersey Medical School, Rutgers University, Newark, NJ, U.S.A. Saint George's University School of Medicine, St. George, Grenada, West Indies
Anticancer Res. 2016 Apr;36(4):1711-8.
BACKGROUND/AIM: Numerous trials have described a wide variation of metabolic complications associated with the mammalian target of rapamycin inhibitors (mTORi). This analysis aimed to report and critically analyze the risks of mTORi-associated metabolic complications.
A comprehensive search of all published phase II or III randomized controlled trials were investigated. Outcomes included were adverse effect profiles of hyperglycemia (HGC), hypertriglyceridemia (HTG), and hypercholesterolemia (HCE).
Sixteen phase II/III clinical trials were identified. The overall incidence of all-grade (AG) and high-grade (HG) metabolic complications associated with mTORi were 39.7% and 4.1% respectively. mTORi use was associated with an increased risk of AG (2.97 [2.25-3.92]) and HG HGC (4.08 [2.71-6.14]), AG (2.22 [1.70-2.89]) and HG HTG (1.88 [1.10-3.20]), and AG (2.48 [1.83-3.36]) and HG HCE (4.26 [2.30-7.90]).
mTORi are associated with a significantly increased risk of AG and HG HGC, HTG, and HCE. Clinicians should be aware of these risks, perform regular monitoring, and consider alternative anti-neoplastic treatments or adjunctive pharmacological intervention if necessary.
背景/目的：众多试验描述了与雷帕霉素靶蛋白抑制剂（mTORi）相关的多种代谢并发症。本分析旨在报告并严格分析mTORi相关代谢并发症的风险。
对所有已发表的II期或III期随机对照试验进行全面检索。纳入的结果包括高血糖（HGC）、高甘油三酯血症（HTG）和高胆固醇血症（HCE）的不良反应情况。
共确定了16项II/III期临床试验。与mTORi相关的所有级别（AG）和高级别（HG）代谢并发症的总体发生率分别为39.7%和4.1%。使用mTORi与AG（2.97 [2.25 - 3.92]）和HG HGC（4.08 [2.71 - 6.14]）、AG（2.22 [1.70 - 2.89]）和HG HTG（1.88 [1.10 - 3.20]）以及AG（2.48 [1.83 - 3.36]）和HG HCE（4.26 [2.30 - 7.90]）风险增加相关。
mTORi与AG和HG HGC、HTG及HCE风险显著增加相关。临床医生应意识到这些风险，定期进行监测，并在必要时考虑替代抗肿瘤治疗或辅助药物干预。
