血管内皮生长因子抑制剂治疗相关肺损伤的发病机制与治疗进展
Antiproteinuric effects of renin-angiotensin inhibitors in lung cancer patients receiving bevacizumab.
机构信息
Division of Clinical Pharmaceutics and Pharmacy Practice, Department of Clinical Pharmacy, Iwate Medical University, School of Pharmacy, 2-1-1, Nishitokuta, Yahaba-cho, Shiwa-gun, 028-3694, Japan.
Department of Pharmacy, Shizuoka Cancer Center, 1007 Shimon agakubo, Nagaizumi-cho, Sunto-gun, 411-8777, Shizuoka Prefecture, Japan.
出版信息
Cancer Chemother Pharmacol. 2018 Jun;81(6):1051-1059. doi: 10.1007/s00280-018-3580-1. Epub 2018 Apr 12.
PURPOSE
The objective of this study was to investigate the effect of renin-angiotensin system inhibitors (RASIs) on bevacizumab (BV)-induced proteinuria in non-small cell lung cancer (NSCLC) patients.
MATERIALS AND METHODS
We retrospectively reviewed the medical records of NSCLC patients receiving BV between 2008 and 2014 at 11 hospitals. The patients were categorized into three groups according to their antihypertensive drug use: RASI user, non-RASI user, and non-user groups. The primary outcome was a proteinuria event of any grade during the first 6 cycles of BV treatment.
RESULTS
A total of 211 patients were included, 89 of whom received antihypertensive drugs. Of these 89 patients, 49 were in the RASI user group, and 40 were in the non-RASI user group. The non-user group comprised 122 patients. The occurrence of proteinuria in the RASI user group was significantly lower than that in the non-RASI user group (P = 0.037) but was not significantly lower than that in the non-user group (P = 0.287). Patients using RASIs had a lower rate of proteinuria than those who did not use RASIs according to multivariate analysis (odds ratio 0.32; 95% confidence interval 0.12-0.86; P = 0.024).
CONCLUSION
Our study suggests that RASI administration reduces the risk of proteinuria in patients receiving BV.
目的
本研究旨在探讨肾素-血管紧张素系统抑制剂（RASI）对非小细胞肺癌（NSCLC）患者贝伐珠单抗（BV）诱导蛋白尿的影响。
材料与方法
我们回顾性分析了 2008 年至 2014 年 11 家医院接受 BV 治疗的 NSCLC 患者的病历。根据降压药物的使用情况，将患者分为 RASI 使用者、非 RASI 使用者和非使用者三组。主要结局为 BV 治疗的前 6 个周期期间任何级别的蛋白尿事件。
结果
共纳入 211 例患者，其中 89 例接受了降压药物治疗。这 89 例患者中，49 例为 RASI 使用者，40 例为非 RASI 使用者，非使用者组有 122 例。RASI 使用者组蛋白尿的发生率明显低于非 RASI 使用者组（P=0.037），但与非使用者组无显著差异（P=0.287）。多变量分析显示，使用 RASIs 的患者蛋白尿发生率低于未使用 RASIs 的患者（比值比 0.32；95%置信区间 0.12-0.86；P=0.024）。
结论
本研究表明，RASI 给药可降低接受 BV 治疗的患者发生蛋白尿的风险。
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