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洛拉替尼治疗 ALK+晚期非小细胞肺癌不良事件管理的专家共识。

Expert Consensus on the Management of Adverse Events of Lorlatinib in the Treatment of ALK+ Advanced Non-small Cell Lung Cancer.

机构信息

Medical Oncology Department, Hospital del Mar, Center for Biomedical Network Research on Cancer (CIBERONC), Barcelona, Spain.

Medical Oncology Department, La Paz University Hospital, Hospital La Paz Health Research Institute (IdiPAZ), Center for Biomedical Network Research on Cancer (CIBERONC), Madrid, Spain.

出版信息

Clin Drug Investig. 2024 Aug;44(8):553-576. doi: 10.1007/s40261-024-01379-7. Epub 2024 Jul 31.

Abstract

The use of anaplastic lymphoma kinase (ALK) tyrosine kinase inhibitors (TKIs), such as lorlatinib, for the treatment of patients with ALK gene rearrangement (or ALK-positive) non-small cell lung cancer (NSCLC) has been shown to improve the overall survival and quality of life of these patients. However, lorlatinib is not exempt from potential adverse events. Adequate monitoring and management of these adverse events are critical for increasing patient adherence to lorlatinib, thereby maximizing the benefits of treatment and minimizing the risks associated with treatment discontinuation. Considering that the adverse events of lorlatinib can affect different organs and systems, the participation of a multidisciplinary team, including cardiologists, neurologists, internal medicine specialists, and oncology pharmacists, is needed. This article presents specific and pragmatic strategies for identifying and treating the most relevant adverse events associated with lorlatinib in patients with advanced ALK-positive NSCLC based on the clinical experience of a multidisciplinary panel of experts.

摘要

使用间变性淋巴瘤激酶(ALK)酪氨酸激酶抑制剂(TKI),如洛拉替尼,治疗 ALK 基因重排(或 ALK 阳性)非小细胞肺癌(NSCLC)患者,已被证明可以改善这些患者的总生存期和生活质量。然而,洛拉替尼并非没有潜在的不良反应。充分监测和管理这些不良反应对于提高患者对洛拉替尼的依从性至关重要,从而最大限度地提高治疗的益处,并最大限度地降低与治疗中断相关的风险。鉴于洛拉替尼的不良反应可能影响不同的器官和系统,需要多学科团队的参与,包括心脏病专家、神经科医生、内科专家和肿瘤药师。本文根据多学科专家小组的临床经验,提出了针对晚期 ALK 阳性 NSCLC 患者与洛拉替尼相关的最相关不良反应的识别和治疗的具体实用策略。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0103/11338981/91b646042a7a/40261_2024_1379_Fig1_HTML.jpg

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