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曲妥珠单抗的药代动力学及其在人表皮生长因子受体 2 阳性癌症患者中的疗效和安全性。

Pharmacokinetics of trastuzumab and its efficacy and safety in HER2-positive cancer patients.

机构信息

Department of Pharmacy, Harbin Medical University Cancer Hospital, Harbin, Heilongjiang, China.

出版信息

Cancer Chemother Pharmacol. 2024 Nov;94(5):721-732. doi: 10.1007/s00280-024-04707-y. Epub 2024 Aug 23.

Abstract

Trastuzumab is a potent targeted therapy drug for HER2-positive cancer patients. A comprehensive understanding of trastuzumab's mechanism of action, pharmacokinetic (PK) parameters, and steady-state exposure in different treatment regimens and administration routes is essential for a thorough evaluation of the drug's safety and effectiveness. Due to the distinctive pharmacokinetics, indications, and administration methods of trastuzumab, this understanding becomes crucial. Drug exposure can be assessed by measuring trastuzumab's peak concentration, trough concentration, or area under the curve through assays like enzyme-linked immunosorbent assay (ELISA) or liquid chromatography-tandem mass spectrometry (LC-MS/MS). The dose-response (D-R) and exposure-response (E-R) relationships establish the correlation between drug dosage/exposure and the therapeutic effect and safety. Additionally, various covariates such as body weight, aspartate transaminase, and albumin levels can influence drug exposure. This review provides a comprehensive overview of trastuzumab's mechanism of action, data on steady-state concentration and PK parameters under multiple administration routes and indications, discussions on factors influencing PK parameters, and evaluations of the effectiveness and safety of E-R and D-R in diverse HER2-positive cancer patients.

摘要

曲妥珠单抗是一种针对 HER2 阳性癌症患者的有效靶向治疗药物。全面了解曲妥珠单抗的作用机制、药代动力学(PK)参数以及不同治疗方案和给药途径的稳态暴露情况,对于全面评估药物的安全性和有效性至关重要。由于曲妥珠单抗具有独特的药代动力学、适应证和给药方法,因此需要深入了解。通过酶联免疫吸附试验(ELISA)或液相色谱-串联质谱(LC-MS/MS)等检测方法,可以通过测量曲妥珠单抗的峰浓度、谷浓度或曲线下面积来评估药物暴露情况。剂量反应(D-R)和暴露反应(E-R)关系建立了药物剂量/暴露与治疗效果和安全性之间的相关性。此外,体重、天冬氨酸转氨酶和白蛋白水平等各种协变量也会影响药物暴露。本综述全面概述了曲妥珠单抗的作用机制、多种给药途径和适应证下稳态浓度和 PK 参数的数据,讨论了影响 PK 参数的因素,并评估了不同 HER2 阳性癌症患者的 E-R 和 D-R 的有效性和安全性。

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