Department I of Internal Medicine and Centre of Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD), University of Cologne, Faculty of Medicine and University Hospital of Cologne, Cologne, Germany.
Expert Rev Hematol. 2020 Mar;13(3):241-257. doi: 10.1080/17474086.2020.1728249. Epub 2020 Feb 17.
: Over the last decade targeted therapies have transformed the treatment landscape for hematologic malignancies with >70 new or extended approvals by the FDA since 2010. Since many of these drugs are registered for multiple entities and >1/3 were approved in the last two years, treatment options in hematology are rapidly expanding. Despite the justified excitement around the often previously unseen emerging therapeutic potential, distinct side-effect profiles require vigilance and adequate management by patients and caregivers.: This review provides a summary of the unique toxicity profiles of therapies for hematologic malignancies during the last decade with a focus on clinical implications and applicability. Due to the already wide implementation in common practice or an immense potential thereof selected treatments such as immune checkpoint inhibitors, various monoclonal antibodies, tyrosine kinase inhibitors and CAR T-cell therapies are discussed in detail. Challenges and potential strategies to assess and manage real-world toxicity after drug approval are addressed.: The rapidly expanding therapeutic landscape of hematologic malignancies comes with a broad spectrum of side effects which are distinct from conventional hematotoxicity and require alertness.
: 在过去的十年中,靶向疗法已经改变了血液系统恶性肿瘤的治疗格局,自 2010 年以来,FDA 批准了超过 70 种新的或扩展的药物。由于许多这些药物针对多种疾病实体注册,并且 >1/3 是在过去两年内批准的,血液学的治疗选择正在迅速扩大。尽管人们对新兴治疗潜力感到非常兴奋,但不同的副作用特征需要患者和护理人员保持警惕并进行充分管理。: 本文综述了过去十年中血液系统恶性肿瘤治疗方法的独特毒性特征,重点介绍了其临床意义和适用性。由于已经在常规实践中广泛应用或具有巨大的潜在应用价值,因此详细讨论了免疫检查点抑制剂、各种单克隆抗体、酪氨酸激酶抑制剂和 CAR T 细胞疗法等选定的治疗方法。文中还讨论了药物批准后评估和管理实际毒性的挑战和潜在策略。: 血液系统恶性肿瘤的治疗领域迅速扩大,带来了广泛的副作用,与传统的血液毒性不同,需要提高警惕。