Imai Hisao, Kaira Kyoichi, Naruse Ichiro, Hayashi Hideki, Iihara Hirotoshi, Kita Yutaro, Mizusaki Naoki, Asao Takayuki, Itoh Yoshinori, Sugiyama Tadashi, Minato Koichi, Yamada Masanobu
Division of Respiratory Medicine, Gunma Prefectural Cancer Center, Gunma, Japan.
Departments of Medicine and Molecular Science, Gunma University Graduate School of Medicine, Gunma, Japan.
Cancer Chemother Pharmacol. 2017 Jan;79(1):209-213. doi: 10.1007/s00280-016-3201-9. Epub 2016 Nov 29.
The treatment for patients with lung cancer undergoing hemodialysis, who are frequently elderly and have poor performance status, becomes a more important subject. However, the feasibility of afatinib in patients with chronic renal failure undergoing hemodialysis has not, so far, been reported. Here, afatinib was administered to three patients with NSCLC harboring EGFR mutation and chronic renal failure undergoing hemodialysis. Pharmacokinetic (PK) data of afatinib supported the safety of afatinib treatment. After receiving their written informed consent from all patients, they were administered 30 mg afatinib daily with HD three times a week. We performed PK analyses of afatinib on days 1, 2, 10, and 11 after initial administration of afatinib. All three patients exhibited a partial response without any serious adverse events during the administration of afatinib. These PK data were similar to those of patients with normal organ function, which were previously reported. Our findings may be particularly useful given the current opportunity to use afatinib as a first-line treatment for EGFR-mutated NSCLC patients, providing an additional option for patients with impaired renal function.
对于经常年老且身体状况较差的接受血液透析的肺癌患者，其治疗成为一个更为重要的课题。然而，目前尚未报道阿法替尼在接受血液透析的慢性肾衰竭患者中的可行性。在此，对三名携带EGFR突变且接受血液透析的慢性肾衰竭非小细胞肺癌患者给予阿法替尼治疗。阿法替尼的药代动力学（PK）数据支持了阿法替尼治疗的安全性。在获得所有患者的书面知情同意后，他们每周进行三次血液透析，同时每天服用30mg阿法替尼。在首次给予阿法替尼后的第1、2、10和11天，我们对阿法替尼进行了PK分析。所有三名患者在服用阿法替尼期间均表现出部分缓解，且未出现任何严重不良事件。这些PK数据与先前报道的器官功能正常的患者的数据相似。鉴于目前有机会将阿法替尼用作EGFR突变的非小细胞肺癌患者的一线治疗药物，我们的研究结果可能特别有用，为肾功能受损的患者提供了另一种选择。
