Yu Zaoqin, Huang Rui, Zhao Li, Wang Ximin, Shangguan Xiaofang, Li Wei, Li Min, Yin Xianguo, Zhang Chengliang, Liu Dong
Department of Pharmacy, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
School of Pharmacy, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Front Oncol. 2021 Oct 21;11:757196. doi: 10.3389/fonc.2021.757196. eCollection 2021.
Oxaliplatin (OXA), a third-generation platinum derivative, has become one of the main chemotherapeutic drugs for colorectal cancer and other cancers, but reports of adverse reactions are also increasing with the extensive application of OXA. In this study, post-marketing surveillance was carried out to investigate the safety profile of OXA in a real-world setting in Chinese cancer patients to provide a reference for the rational application of OXA.
All patients with cancer who received OXA-based chemotherapy in 10 tertiary hospitals in Hubei Province, China, between May 2016 and November 2016 were enrolled. A central registration method was used to document patients' demographics, clinical use, and any incidence of adverse reactions to OXA. All adverse drug reactions (ADRs) were collected and analyzed to assess causality, severity, treatment, and outcome.
In total, 3687 patients were enrolled in this study. Approximately 64.6% of the patients were male, and 68.8% were aged 50-70 years, with a mean age of 55.3 years. The proportions of patients diagnosed with colorectal and gastric cancers were 59.3% and 31.6%, respectively. In this study, the overall incidence of ADRs and serious ADRs was 42.7% and 1.3%, respectively. The most common ADRs were gastrointestinal disorders (25.7%), blood disorders (21.1%), and peripheral nervous system disorders (8.0%). The serious ADRs identified were hypersensitivity reactions, thrombocytopenia, abnormal hepatic function, and leukopenia/neutropenia. The median onset of gastrointestinal toxicity, myelosuppression, peripheral neurotoxicity, and abnormal hepatic function was 1 d, 5 d, 1 d, and 14 d, respectively. The majority (84.7%) of hypersensitivity reactions were mild to moderate, and the median time to onset of these reactions was within the first 20 min of OXA infusion. Almost 88.0% of patients who experienced ADRs recovered or improved with treatment.
Our data suggest that OXA-induced ADRs are very common in Chinese patients with cancer; however, more attention should be paid to hypersensitivity reactions caused by OXA. This study provides a valuable reference regarding the safe application of OXA in a real-world setting.
奥沙利铂(OXA)作为第三代铂类衍生物,已成为治疗结直肠癌及其他癌症的主要化疗药物之一,但随着奥沙利铂的广泛应用,其不良反应的报道也日益增多。本研究通过开展上市后监测,调查奥沙利铂在中国癌症患者真实世界中的安全性,为奥沙利铂的合理应用提供参考。
纳入2016年5月至2016年11月在中国湖北省10家三级医院接受以奥沙利铂为基础化疗的所有癌症患者。采用集中登记的方法记录患者的人口统计学信息、临床用药情况以及奥沙利铂不良反应的发生情况。收集并分析所有药物不良反应(ADR),以评估因果关系、严重程度、治疗方法及转归。
本研究共纳入3687例患者。约64.6%的患者为男性,68.8%的患者年龄在50 - 70岁之间,平均年龄为55.3岁。诊断为结直肠癌和胃癌的患者比例分别为59.3%和31.6%。本研究中,ADR和严重ADR的总体发生率分别为42.7%和1.3%。最常见的ADR为胃肠道疾病(25.7%)、血液系统疾病(21.1%)和周围神经系统疾病(8.0%)。确定的严重ADR为过敏反应、血小板减少、肝功能异常和白细胞减少/中性粒细胞减少。胃肠道毒性、骨髓抑制、周围神经毒性和肝功能异常的中位发病时间分别为1天、5天、1天和14天。大多数(84.7%)过敏反应为轻至中度,这些反应的中位发病时间在奥沙利铂输注的前20分钟内。几乎88.0%发生ADR的患者经治疗后恢复或好转。
我们的数据表明,奥沙利铂引起不良反应在中国癌症患者中非常常见;然而,应更加关注奥沙利铂引起的过敏反应。本研究为奥沙利铂在真实世界中的安全应用提供了有价值的参考。