Aw Derrick Chen-Wee, Tan Eng Huat, Chin Tan Min, Lim Hong Liang, Lee Haur Yueh, Soo Ross A
Department of General Medicine, Sengkang Health, Alexandra Hospital, Singapore.
Division of Medical Oncology, National Cancer Centre, Singapore.
Asia Pac J Clin Oncol. 2018 Feb;14(1):23-31. doi: 10.1111/ajco.12687. Epub 2017 May 2.
Patients with advanced stage non-small cell lung cancer with sensitizing epidermal growth factor receptor (EGFR) mutations using EGFR tyrosine kinase inhibitors (TKIs) such as erlotinib, gefitinib and afatinib as first-line treatment had better progression-free survival, overall response rate and quality of life than those on chemotherapy. Although EGFR TKIs are commonly associated with skin-related (rash, xerosis and paronychia) and gastrointestinal-related (diarrhea and stomatitis) adverse events (AEs), these effects are usually mild. But severe cases can occur, significantly affecting patient's well-being, treatment compliance and quality of life. Therefore, patient education, early diagnosis, and prophylactic treatment are important strategies to optimally manage EGFR TKI-related adverse effects. In this review, we summarize the commonly encountered EGFR TKI-related AEs and provide a current overview of AE management in local practice with a focus on Asian patients.
对于晚期非小细胞肺癌且具有敏感表皮生长因子受体(EGFR)突变的患者,使用厄洛替尼、吉非替尼和阿法替尼等EGFR酪氨酸激酶抑制剂(TKIs)作为一线治疗,其无进展生存期、总体缓解率和生活质量均优于接受化疗的患者。尽管EGFR TKIs通常与皮肤相关(皮疹、皮肤干燥和甲沟炎)及胃肠道相关(腹泻和口腔炎)不良事件(AEs)有关,但这些影响通常较轻。不过也可能出现严重病例,显著影响患者的健康、治疗依从性和生活质量。因此,患者教育、早期诊断和预防性治疗是优化管理EGFR TKI相关不良反应的重要策略。在本综述中,我们总结了常见的EGFR TKI相关AEs,并提供了当地实践中AE管理的当前概述,重点关注亚洲患者。