Zhang L, Yang Y P
Department of Medical Oncology, Sun Yat-Sen University Cancer Center, Guangzhou 510060.
Zhonghua Zhong Liu Za Zhi. 2022 Apr 23;44(4):297-307. doi: 10.3760/cma.j.cn112152-20220113-00033.
The mutation rate of anaplastic lymphoma kinase (ALK) in patients with non-small cell lung cancer is 3% to 7%. Due to its low mutation rate and better long-term survival compared with epidermal growth factor receptor-positive non-small cell lung cancer patients, therefore, it's called "diamond mutation". At present, there are three generations of ALK tyrosine kinase inhibitor (TKI) drugs in the world. The first-generation ALK-TKI drug approved in China is crizotinib, and the second-generation drugs are alectinib, ceritinib and ensartinib. Among them, ensartinib is an ALK-TKI domestically developed, and its efficacy is similar to that of alectinib. The main adverse event is transient rash, and compliance to ensartinib is better from the perspective of long-term survival of patients. The manifestation of rash caused by ensartinib is different from that of other ALK-TKI drugs. In order to facilitate clinical application and provide patients with more treatment options, under the guidance of the Committee of Cancer Rehabilitation and Palliative Care of China Anti-Cancer Association, this article collects and summarizes the common adverse reactions of ensartinib. Based on the clinical practice, a clear adverse classification and specific treatment plan are formulated, in order to provide a corresponding reference for clinicians to make more comprehensive clinical decisions.
非小细胞肺癌患者中间变性淋巴瘤激酶(ALK)的突变率为3%至7%。由于其突变率较低,与表皮生长因子受体阳性的非小细胞肺癌患者相比长期生存率更佳,因此,它被称为“钻石突变”。目前,全球有三代ALK酪氨酸激酶抑制剂(TKI)药物。中国批准的第一代ALK-TKI药物是克唑替尼,第二代药物是阿来替尼、色瑞替尼和恩沙替尼。其中,恩沙替尼是国内研发的ALK-TKI,其疗效与阿来替尼相似。主要不良事件是短暂性皮疹,从患者长期生存角度来看,恩沙替尼的依从性更好。恩沙替尼引起的皮疹表现与其他ALK-TKI药物不同。为便于临床应用,为患者提供更多治疗选择,在中国抗癌协会癌症康复与姑息治疗专业委员会指导下,本文收集并总结了恩沙替尼的常见不良反应。基于临床实践,制定明确的不良反应分类及具体治疗方案,以便为临床医生做出更全面的临床决策提供相应参考。