van der Werf A, Rovithi M, Langius J A E, de van der Schueren M A E, Verheul H M W
Department of Medical Oncology, Cancer Center Amsterdam, VU University Medical Center, P.O. Box 7057, 1081 HV, Amsterdam, The Netherlands; Department of Nutrition and Dietetics, Internal Medicine, VU University Medical Center, P.O. Box 7057, 1081 HV, Amsterdam, The Netherlands.
Department of Medical Oncology, Cancer Center Amsterdam, VU University Medical Center, P.O. Box 7057, 1081 HV, Amsterdam, The Netherlands; Medical Oncology Unit, Department of Internal Medicine, Agios Nikolaos General Hospital, Const. Paleologos & Knossos, PC 72100, Agios Nikolaos, Crete, Greece.
Eur J Cancer. 2017 Nov;86:125-134. doi: 10.1016/j.ejca.2017.09.006. Epub 2017 Oct 4.
The role of Protein Kinase Inhibitors (PKI) in the treatment of various types of cancer is increasingly prominent. Their clinical application is accompanied by the development of side effects, among which patient-reported taste alterations. These alterations are missed frequently, but impair nutritional intake, are associated with weight loss and often result in significant morbidity, especially in the context of chronic administration. Accurate reporting of taste alterations is hampered by lack of modules for symptom objectification and inadequate understanding on the underlying mechanisms. In this review we initially describe the physiology of taste and smell and the mechanism of action of PKIs. We proceed to summarize taste related side effects as reported in major clinical trials and describe possible causal factors. Lastly, an in-depth analysis is given on potential molecular pathways responsible for the PKI-induced taste alterations. Objectification of patient-reported symptoms and universal reporting, along with a better understanding of the underlying mechanisms, will lead to early recognition and optimized treatment, ultimately improving patient adherence and quality of life.
蛋白激酶抑制剂（PKI）在各类癌症治疗中的作用日益显著。其临床应用伴随着副作用的出现，其中患者报告的味觉改变较为常见。这些改变常常被忽视，但会影响营养摄入，导致体重减轻，并常常引发严重的健康问题，尤其是在长期用药的情况下。由于缺乏症状客观化模块以及对潜在机制的理解不足，味觉改变的准确报告受到阻碍。在本综述中，我们首先描述味觉和嗅觉的生理学以及PKI的作用机制。接着，我们总结主要临床试验中报告的与味觉相关的副作用，并描述可能的因果因素。最后，深入分析导致PKI引起味觉改变的潜在分子途径。患者报告症状的客观化和统一报告，以及对潜在机制的更好理解，将有助于早期识别和优化治疗，最终提高患者的依从性和生活质量。
