Lan Chou-Chin, Hsieh Po-Chun, Huang Chun-Yao, Yang Mei-Chen, Su Wen-Lin, Wu Chih-Wei, Wu Yao-Kuang
Division of Pulmonary Medicine, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei City 23142, Taiwan.
Department of Chinese Medicine, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei City 23142, Taiwan.
World J Clin Cases. 2022 Jul 6;10(19):6360-6369. doi: 10.12998/wjcc.v10.i19.6360.
Non-small-cell lung cancer (NSCLC) causes significant mortality worldwide. Patients with chronic renal failure have an increased risk of developing lung cancer. NSCLC Patients with chronic renal failure undergoing hemodialysis (HD) often exhibit poor performance, and chemotherapy is generally contraindicated. Oral epidermal growth factor receptor (EGFR)-tyrosine kinase inhibitors (TKIs) are effective treatment agents for NSCLC patients. However, the benefits and adverse effects of EGFR-TKIs in NSCLC undergoing HD are known. There are no clinical studies on the effects of EGFR-TKIs on NSCLC patients undergoing HD. We reviewed all previous case reports about EGFR-TKIs in NSCLC patients undergoing HD. It is difficult to design studies about the effects of EGFR-TKIs in patients undergoing HD, and this review is quite important. EGFR-TKIs are well tolerated in patients undergoing HD. The main routes of elimination of EGFR-TKIs are metabolism the liver, and renal elimination is minor. The recommended doses and pharmacokinetics of these EGFR-TKIs for patients undergoing HD are similar to those for patients with normal renal function. The plasma protein binding of EGFR-TKIs is very high, and it is not necessary to adjust the dose after HD. In conclusion, EGFR-TKIs are effective and well tolerated in patients undergoing HD.
非小细胞肺癌(NSCLC)在全球范围内导致了显著的死亡率。慢性肾衰竭患者患肺癌的风险增加。接受血液透析(HD)的NSCLC合并慢性肾衰竭患者通常表现较差,化疗一般为禁忌。口服表皮生长因子受体(EGFR)-酪氨酸激酶抑制剂(TKIs)是NSCLC患者的有效治疗药物。然而,EGFR-TKIs在接受HD的NSCLC患者中的获益和不良反应尚不清楚。目前尚无关于EGFR-TKIs对接受HD的NSCLC患者影响的临床研究。我们回顾了既往所有关于接受HD的NSCLC患者使用EGFR-TKIs的病例报告。设计关于EGFR-TKIs对接受HD患者影响的研究很困难,因此本综述相当重要。接受HD的患者对EGFR-TKIs耐受性良好。EGFR-TKIs的主要消除途径是肝脏代谢,肾脏消除作用较小。这些EGFR-TKIs用于接受HD患者的推荐剂量和药代动力学与肾功能正常的患者相似。EGFR-TKIs的血浆蛋白结合率非常高,血液透析后无需调整剂量。总之,EGFR-TKIs在接受HD的患者中有效且耐受性良好。