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肝功能或肾功能损害的非小细胞肺癌患者的酪氨酸激酶抑制剂的剂量调整(综述)。

Dose adjustment for tyrosine kinase inhibitors in non‑small cell lung cancer patients with hepatic or renal function impairment (Review).

机构信息

Department of Clinical Pharmacy, The Third Hospital of Mianyang (Sichuan Mental Health Center), Mianyang, Sichuan 621000, P.R. China.

出版信息

Oncol Rep. 2021 Feb;45(2):413-426. doi: 10.3892/or.2020.7870. Epub 2020 Nov 27.

Abstract

In recent years, a number of tyrosine kinase inhibitors (TKIs) have been approved for the treatment of non‑small cell lung cancer. These novel treatments exhibit improved efficacy and toxicity when compared to conventional chemotherapy agents. TKIs are administered orally, which has the advantages of improved flexibility and convenience for the patients. However, challenges have arisen in the use of these novel agents. Prescribing drugs for patients with hepatic or renal function impairment poses a challenge for clinicians due to the large pharmacokinetic variability in each individual patient. Moreover, several TKIs have been shown to cause laboratory test abnormalities normally associated with hepatic or renal injury. The aim of the present review was to discuss the effects of hepatic and renal function impairment on the pharmacokinetic variability of 17 TKIs and their potential hepatotoxicity and nephrotoxicity, and to recommend dose adjustment for patients with hepatic or renal impairment.

摘要

近年来,已有多种酪氨酸激酶抑制剂(TKI)获批用于治疗非小细胞肺癌。与传统化疗药物相比,这些新型治疗方法具有更好的疗效和更低的毒性。TKI 是口服给药的,这为患者提供了更好的灵活性和便利性。然而,在使用这些新型药物时也出现了一些挑战。由于每个个体患者的药代动力学变异性较大,对于肝肾功能受损的患者,临床医生在开具药物处方时面临挑战。此外,多项研究表明,一些 TKI 可引起实验室检查异常,通常与肝或肾损伤有关。本综述的目的是讨论肝肾功能损害对 17 种 TKI 的药代动力学变异性及其潜在肝毒性和肾毒性的影响,并为肝肾功能损害患者推荐剂量调整。

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