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胸部肿瘤治疗电场(TTFields)疗法所致皮肤不良事件的预防与治疗专家指导意见

Expert guidance on prophylaxis and treatment of dermatologic adverse events with Tumor Treating Fields (TTFields) therapy in the thoracic region.

作者信息

Anadkat Milan J, Lacouture Mario, Friedman Adam, Horne Zachary D, Jung Jae, Kaffenberger Benjamin, Kalmadi Sujith, Ovington Liza, Kotecha Rupesh, Abdullah Huda Ismail, Grosso Federica

机构信息

Division of Dermatology, Department of Medicine, Washington University, St. Louis, MO, United States.

Dermatology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, United States.

出版信息

Front Oncol. 2023 Jan 4;12:975473. doi: 10.3389/fonc.2022.975473. eCollection 2022.

Abstract

Tumor Treating Fields (TTFields) are electric fields, delivered via wearable arrays placed on or near the tumor site, that exert physical forces to disrupt cellular processes critical for cancer cell viability and tumor progression. As a first-in-class treatment, TTFields therapy is approved for use in newly diagnosed glioblastoma, recurrent glioblastoma, and pleural mesothelioma. Additionally, TTFields therapy is being investigated in non-small cell lung cancer (NSCLC), brain metastases from NSCLC, pancreatic cancer, ovarian cancer, hepatocellular carcinoma, and gastric adenocarcinoma. Because TTFields therapy is well tolerated and delivery is locoregional, there is low risk of additive systemic adverse events (AEs) when used with other cancer treatment modalities. The most common AE associated with TTFields therapy is mild-to-moderate skin events, which can be treated with topical agents and may be managed without significant treatment interruptions. Currently, there are no guidelines for oncologists regarding the management of TTFields therapy-related skin AEs in the thoracic region, applicable for patients with pleural mesothelioma or NSCLC. This publication aims to provide guidance on preventing, minimizing, and managing dermatologic AEs in the thoracic region to help improve patient quality of life and reduce treatment interruptions that may impact outcomes with TTFields therapy.

摘要

肿瘤治疗电场(TTFields)是通过放置在肿瘤部位或其附近的可穿戴阵列传递的电场,其施加物理力来破坏对癌细胞生存能力和肿瘤进展至关重要的细胞过程。作为一种一流的治疗方法,TTFields疗法已被批准用于新诊断的胶质母细胞瘤、复发性胶质母细胞瘤和胸膜间皮瘤。此外,正在对非小细胞肺癌(NSCLC)、NSCLC脑转移瘤、胰腺癌、卵巢癌、肝细胞癌和胃腺癌进行TTFields疗法的研究。由于TTFields疗法耐受性良好且给药是局部性的,与其他癌症治疗方式联合使用时发生全身性不良事件(AE)叠加的风险较低。与TTFields疗法相关的最常见AE是轻度至中度皮肤事件,可用局部用药治疗,且在不显著中断治疗的情况下即可处理。目前,对于治疗胸膜间皮瘤或NSCLC患者时TTFields疗法相关的胸部皮肤AE的管理,肿瘤学家尚无相关指南。本出版物旨在为预防、最小化和管理胸部皮肤AE提供指导,以帮助提高患者生活质量,并减少可能影响TTFields疗法疗效的治疗中断情况。

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