一名接受阿培利司治疗的转移性乳腺癌患者的肿瘤溶解综合征
Tumor lysis Syndrome in a Patient with Metastatic Breast Cancer Treated with Alpelisib.
作者信息
Handy Caitlin, Wesolowski Robert, Gillespie Michelle, Lause Michael, Sardesai Sagar, Williams Nicole, Grimm Michael, Kassem Mahmoud, Ramaswamy Bhuvaneswari
机构信息
Department of Internal Medicine, The Ohio State University Wexner Medical Center, Columbus, OH, USA.
Division of Medical Oncology, Department of Internal Medicine, The Ohio State University Comprehensive Cancer Center, Columbus, OH, USA.
出版信息
Breast Cancer (Auckl). 2021 Aug 29;15:11782234211037421. doi: 10.1177/11782234211037421. eCollection 2021.
PURPOSE
Tumor lysis syndrome (TLS) is a rare but life-threatening phenomenon that occurs mainly in patients with aggressive hematologic or highly chemotherapy sensitive solid tumors such as high-grade neuroendocrine carcinoma or testicular cancer. Tumor lysis syndrome is exceedingly rare in hormone receptor-positive, HER2-negative breast cancer. Furthermore, TLS following treatment with alpelisib, a novel phosphatidylinositol 3-kinase (PI3K) inhibitor used to treat -mutated (gene encoding p110α subunit of PI3K), hormone receptor positive advanced breast cancer, has never been described in patients with nonhematologic malignancies.
METHODS
In the following case, we present a patient with hormone receptor-positive, HER2-negative, -mutated metastatic breast cancer who developed TLS 12 days after starting fulvestrant and alpelisib.
RESULTS
Patient was promptly treated with improvement in her renal function to baseline without requiring renal replacement therapy. Alpelisib was resumed at a reduced dose with no further complications.
CONCLUSION
Through this case, we discuss the potential complications of TLS and the importance of prompt recognition and treatment.
目的
肿瘤溶解综合征（TLS）是一种罕见但危及生命的现象，主要发生于侵袭性血液系统疾病患者或对化疗高度敏感的实体瘤患者，如高级别神经内分泌癌或睾丸癌。肿瘤溶解综合征在激素受体阳性、人表皮生长因子受体2（HER2）阴性乳腺癌中极为罕见。此外，alpelisib是一种用于治疗PIK3CA突变（PI3K的p110α亚基编码基因）、激素受体阳性晚期乳腺癌的新型磷脂酰肌醇3激酶（PI3K）抑制剂，非血液系统恶性肿瘤患者使用alpelisib治疗后发生TLS的情况此前从未有过报道。
方法
在以下病例中，我们介绍了一名激素受体阳性、HER2阴性、PIK3CA突变的转移性乳腺癌患者，在开始使用氟维司群和alpelisib治疗12天后发生了TLS。
结果
患者得到及时治疗，肾功能恢复至基线水平，无需进行肾脏替代治疗。alpelisib以减量后的剂量重新开始使用，未再出现其他并发症。
结论
通过该病例，我们讨论了TLS的潜在并发症以及及时识别和治疗的重要性。
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