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分子靶向治疗的皮肤毒性

Cutaneous Toxicities of Molecular Targeted Therapies.

作者信息

Stanculeanu Dana Lucia, Zob Daniela, Toma Oana Catalina, Georgescu Bogdan, Papagheorghe Laura, Mihaila Raluca Ioana

机构信息

Medical Oncology Department, "Prof. Dr. Al. Trestioreanu" Institute of Oncology, Bucharest, Romania ; Oncology Department, "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania.

Medical Oncology Department, "Prof. Dr. Al. Trestioreanu" Institute of Oncology, Bucharest, Romania.

出版信息

Maedica (Bucur). 2017 Jan;12(1):48-54.

Abstract

Antineoplastic targeted therapies, such as EGFR inhibitors, tyrosine kinase inhibitors and BRAF inhibitors, frequently lead to systemic and cutaneous side effects, significantly affecting patient's quality of life. Patients with new targeted therapies have an increased risk of developing skin reactions. The new molecular target therapies developed in the last decades can induce severe skin reactions, which may require dose reduction or discontinuation of treatment and consequently, a decrease in patient's quality of life. The present paper describes toxic cutaneous reactions associated with the most frequently used molecular therapies (epidermal growth factor receptor inhibitors, tyrosine kinase inhibitors, BRAF-inhibitors), frequency of occurrence and methods of diagnosis and treatment, in order to offer a clinically efficient management for maintaining a good quality of life, with compliance to treatment and good therapeutic efficacy. Knowledge of cutaneous adverse reactions in new therapies is mandatory in order to have a proper management of oncologic patients. Recognizing target therapy toxicities by both oncologists and dermatologists, understanding therapeutic mechanisms and choosing optimum treatments for oncologic patients are critical. A correct evaluation of skin toxicity can allow for an adequate decision regarding treatment dose or discontinuation, impacting therapy response and patient survival.

摘要

抗肿瘤靶向治疗,如表皮生长因子受体(EGFR)抑制剂、酪氨酸激酶抑制剂和BRAF抑制剂,常常会导致全身和皮肤副作用,严重影响患者的生活质量。接受新型靶向治疗的患者发生皮肤反应的风险增加。过去几十年开发的新型分子靶向治疗可引发严重的皮肤反应,这可能需要减少剂量或停止治疗,进而导致患者生活质量下降。本文描述了与最常用分子治疗(表皮生长因子受体抑制剂、酪氨酸激酶抑制剂、BRAF抑制剂)相关的皮肤毒性反应、发生频率以及诊断和治疗方法,以便提供一种临床有效的管理方法,在确保治疗依从性和良好疗效的同时维持良好的生活质量。了解新型治疗中的皮肤不良反应对于妥善管理肿瘤患者至关重要。肿瘤学家和皮肤科医生识别靶向治疗毒性、理解治疗机制并为肿瘤患者选择最佳治疗方法至关重要。正确评估皮肤毒性可就治疗剂量或停药做出适当决策,从而影响治疗反应和患者生存。

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