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间质性肺病风险的间变性淋巴瘤激酶酪氨酸激酶抑制剂治疗非小细胞肺癌:一个真实世界的药物警戒研究。

Interstitial lung disease risk of anaplastic lymphoma kinase tyrosine kinase inhibitor treatment of non-small cell lung cancer: a real-world pharmacovigilance study.

机构信息

Department of Pharmacy, The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine), Hangzhou, China.

Department of Pharmacy, Affiliated Qingdao Third People's Hospital, Qingdao University, Qingdao, China.

出版信息

Expert Opin Drug Saf. 2023 Jul-Dec;22(12):1309-1316. doi: 10.1080/14740338.2023.2245324. Epub 2023 Aug 12.

DOI:10.1080/14740338.2023.2245324
PMID:37551674
Abstract

BACKGROUND

Interstitial lung disease (ILD) is a rare but life-threatening and fatal treatment-related pneumonitis. This study investigated the association between anaplastic lymphoma kinase tyrosine kinase inhibitors (ALK-TKIs) and ILD.

RESEARCH DESIGN AND METHODS

Cases of ILD that developed after treatment with an ALK-TKI in the Food and Drug Administration' s Adverse Event Reporting System (FAERS) data were assessed. We also described the clinical features of these cases and evaluated onset time, hospitalization, life-threatening condition, and fatality rate of ILD developed after treatment with an ALK-TKI.

RESULTS

All five ALK-TKI regimens were significantly associated with ILD. The median onset time to ILD was significantly different for brigatinib, crizotinib, alectinib, lorlatinib, and ceritinib: 4.5, 25, 35.5, 54.5, and 84 days, respectively. ALK-TKI-associated ILD resulted in hospitalization in 55.77% of patients and death or life-threatening outcomes in 43.03%. The highest and lowest proportions of ILD-related fatalities were observed after crizotinib and alectinib treatment, respectively.

CONCLUSIONS

ALK-TKIs were associated with ILD; therefore, the risk of developing ILD after treatment with an ALK-TKI should be carefully considered in clinical settings.

摘要

背景

间质性肺病(ILD)是一种罕见但危及生命和致命的治疗相关肺炎。本研究调查了间变性淋巴瘤激酶酪氨酸激酶抑制剂(ALK-TKI)与ILD 之间的关联。

研究设计和方法

评估了食品和药物管理局不良事件报告系统(FAERS)数据中治疗后发生 ILD 的 ALK-TKI 病例。我们还描述了这些病例的临床特征,并评估了治疗后发生的 ALK-TKI 相关 ILD 的发病时间、住院、危及生命的情况和死亡率。

结果

所有五种 ALK-TKI 方案均与 ILD 显著相关。brigatinib、crizotinib、alectinib、lorlatinib 和 ceritinib 发生 ILD 的中位发病时间分别为 4.5、25、35.5、54.5 和 84 天。ALK-TKI 相关 ILD 导致 55.77%的患者住院,43.03%的患者出现死亡或危及生命的结局。在接受克唑替尼和阿来替尼治疗后,分别观察到 ILD 相关死亡率的最高和最低比例。

结论

ALK-TKIs 与 ILD 相关;因此,在临床环境中应仔细考虑治疗后发生 ILD 的风险。

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引用本文的文献

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[Recent Advances in the Treatment of Non-small Cell Lung Cancer with Brigatinib].[布加替尼治疗非小细胞肺癌的最新进展]
Zhongguo Fei Ai Za Zhi. 2025 Jun 20;28(6):450-459. doi: 10.3779/j.issn.1009-3419.2025.106.12.
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Interstitial lung disease associated with ALK inhibitors and risk factors: an updated comparative pharmacovigilance analysis.间质性肺疾病与ALK抑制剂及危险因素:一项更新的比较药物警戒分析
Front Pharmacol. 2024 Sep 27;15:1361443. doi: 10.3389/fphar.2024.1361443. eCollection 2024.
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Post-marketing safety of lorlatinib: a real-world study based on the FDA adverse event reporting system.
洛拉替尼的上市后安全性:一项基于美国食品药品监督管理局不良事件报告系统的真实世界研究。
Front Pharmacol. 2024 Jun 5;15:1385036. doi: 10.3389/fphar.2024.1385036. eCollection 2024.