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曲妥珠单抗和帕妥珠单抗相关的 HER2 阳性乳腺癌患者瘙痒。

Pruritus related to trastuzumab and pertuzumab in HER2 + breast cancer patients.

机构信息

Dermatology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, 545 East 73rd Street, New York, NY, 10021, USA.

Dermatopathology Service, Department of Pathology and Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York, USA.

出版信息

Breast Cancer Res Treat. 2024 Jan;203(2):271-280. doi: 10.1007/s10549-023-07143-3. Epub 2023 Oct 13.

DOI:10.1007/s10549-023-07143-3
PMID:37833451
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10787687/
Abstract

PURPOSE

The combination of trastuzumab and pertuzumab (HP) as part of a taxane-based regimen has shown benefit in the adjuvant and metastatic HER2 + breast cancer setting. In the CLEOPATRA trial, pruritus was reported in 11-17.6% of patients. The clinical phenotype and potential treatment strategies for this event have not been reported.

METHODS

A retrospective review of 2583 patients receiving trastuzumab and pertuzumab for the treatment of HER2 + breast cancer from 11/23/2011 to 6/21/2021 was performed at Memorial Sloan Kettering Cancer Center (MSKCC). Patient demographics, pruritus characteristics, and treatments as documented in the electronic medical record (EMR) were included in this analysis.

RESULTS

Of 2583 pts treated with HP, 122 (4.72%) with pruritus were identified. On average, patients experienced pruritus 319.0 days (8-3171) after initiation of HP. The upper extremities (67.4%), back (29.3%), lower extremities (17.4%), and shoulders (14.1%) were the most commonly affected regions. Grade 1/2 pruritus (97.6%) occurred in most cases. Patients responded primarily to treatment with topical steroids (52.2%), antihistamines (29.9%), emollients (20.9%), and gabapentinoids (16.4%). Of those with pruritus, 4 patients (3.3%) required treatment interruption or discontinuation.

CONCLUSIONS

Pruritus is uncommon in patients on trastuzumab and pertuzumab, generally a chronic condition, with gabapentinoids or antihistamines representing effective therapies.

摘要

目的

曲妥珠单抗和帕妥珠单抗（HP）联合作为紫杉烷类药物方案的一部分，在辅助和转移性 HER2+乳腺癌治疗中显示出获益。在 CLEOPATRA 试验中，有 11-17.6%的患者报告有瘙痒。目前尚未报道这种事件的临床表型和潜在治疗策略。

方法

对 2011 年 11 月 23 日至 2021 年 6 月 21 日期间在 Memorial Sloan Kettering Cancer Center（MSKCC）接受曲妥珠单抗和帕妥珠单抗治疗 HER2+乳腺癌的 2583 例患者进行回顾性分析。本分析纳入了患者人口统计学资料、瘙痒特征和电子病历（EMR）中记录的治疗方法。

结果

在接受 HP 治疗的 2583 例患者中，有 122 例（4.72%）发生瘙痒。HP 治疗开始后，患者平均 319.0 天（8-3171 天）出现瘙痒。最常受累的部位是上肢（67.4%）、背部（29.3%）、下肢（17.4%）和肩部（14.1%）。大多数病例为 1/2 级瘙痒（97.6%）。患者主要接受外用皮质类固醇（52.2%）、抗组胺药（29.9%）、保湿剂（20.9%）和加巴喷丁类药物（16.4%）治疗。有瘙痒的患者中，有 4 例（3.3%）需要中断或停止治疗。

结论

曲妥珠单抗和帕妥珠单抗治疗患者中瘙痒并不常见，通常为慢性疾病，加巴喷丁类药物或抗组胺药是有效的治疗药物。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9b88/10787687/8451d0af9c50/10549_2023_7143_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9b88/10787687/d1b5db4f9c1d/10549_2023_7143_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9b88/10787687/409670711bd4/10549_2023_7143_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9b88/10787687/8451d0af9c50/10549_2023_7143_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9b88/10787687/d1b5db4f9c1d/10549_2023_7143_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9b88/10787687/409670711bd4/10549_2023_7143_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9b88/10787687/8451d0af9c50/10549_2023_7143_Fig3_HTML.jpg

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