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非小细胞肺癌患者中卡铂诱导的电解质异常的发生率及生理机制

Incidence and physiological mechanism of carboplatin-induced electrolyte abnormality among patients with non-small cell lung cancer.

作者信息

Ma Yushui, Hou Likun, Yu Fei, Lu Gaixia, Qin Shanshan, Xie Ruting, Yang Huiqiong, Wu Tingmiao, Luo Pei, Chai Li, Lv Zhongwei, Peng Xiaodong, Wu Chunyan, Fu Da

机构信息

Department of Nuclear Medicine, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China.

Shanghai Engineering Research Center of Molecular Therapeutics and New Drug Development, College of Chemistry and Molecular Engineering, East China Normal University, Shanghai, China.

出版信息

Oncotarget. 2017 Mar 14;8(11):18417-18423. doi: 10.18632/oncotarget.12813.

Abstract

To clarify the association between carboplatin and electrolyte abnormality, a pooled-analysis was performed with the adverse event reports of non-small cell lung cancer patients. A total of 19901 adverse events were retrieved from the FDA Adverse Event Reporting System (FAERS). Pooled reporting odds ratios (RORs) and 95% CIs suggested that carboplatin was significantly associated with hyponatremia (pooled ROR = 1.57, 95% CI 1.18-2.09, P = 1.99×10-3) and hypokalemia (pooled ROR = 2.37, 95% CI 1.80-3.10, P = 5.24×10-10) as compared to other therapies. In addition, we found that dehydration was frequently concurrent with carboplatin therapy (pooled ROR = 2.01, 95% CI 1.52-2.66, P = 8.37×10-7), which may prompt excessive water ingestion and decrease serum electrolyte concentrations. This information has not been mentioned in the FDA-approved drug label and could help explain the physiological mechanism of carboplatin-induced electrolyte abnormality. In conclusion, the above results will facilitate clinical management and prompt intervention of life-threatening electrolyte imbalance in the course of cancer treatment.

摘要

为阐明卡铂与电解质异常之间的关联,我们对非小细胞肺癌患者的不良事件报告进行了汇总分析。共从美国食品药品监督管理局不良事件报告系统(FAERS)中检索到19901例不良事件。汇总报告比值比(ROR)及95%置信区间表明,与其他治疗方法相比,卡铂与低钠血症(汇总ROR = 1.57,95%置信区间1.18 - 2.09,P = 1.99×10⁻³)和低钾血症(汇总ROR = 2.37,95%置信区间1.80 - 3.10,P = 5.24×10⁻¹⁰)显著相关。此外,我们发现脱水常与卡铂治疗同时发生(汇总ROR = 2.01,95%置信区间1.52 - 2.66,P = 8.37×10⁻⁷),这可能促使患者过度饮水并降低血清电解质浓度。这一信息在FDA批准的药品标签中未被提及,且有助于解释卡铂诱导电解质异常的生理机制。总之,上述结果将有助于癌症治疗过程中危及生命的电解质失衡的临床管理及及时干预。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b2c7/5392339/751761ca31b8/oncotarget-08-18417-g001.jpg

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