Chin Alan, Lindsay Sheila, Bergsland Emily K, Kang Hyunseok
Department of Pharmacy, University of California San Francisco Medical Center, San Francisco, CA, USA.
University of California, San Francisco-Helen Diller Family Comprehensive Cancer Center, San Francisco, CA, USA.
J Oncol Pharm Pract. 2025 Jan;31(1):147-150. doi: 10.1177/10781552241279196. Epub 2024 Aug 27.
This article aims to expand on the existing literature regarding the incidence of withdrawal pain following discontinuation of Trk inhibitors and to explore strategies that mitigate this withdrawal pain.
A retrospective observational study was conducted among patients who were at least 18 years-old or older and had documentation of starting larotrectinib or entrectinib at University of California, San Francisco (UCSF) between November 2018 and November 2022. Data were collected from electronic records and pharmacy databases and a total of 21 patients were identified in this study.
Of the 21 patients included in this study, five patients (24%) experienced pain during temporary or permanent discontinuation of Trk inhibitor with the onset of withdrawal pain ranging from a few hours to three days following discontinuation. Various strategies were implemented to manage this pain including restarting of Trk inhibitor, tapering of Trk inhibitor on discontinuation, minimizing dose interruptions and use of prescription pain medications.
This article illustrates the presence of withdrawal pain syndrome in patients stopping a Trk inhibitor treatment and highlight the need for patient education to avoid missing any doses and for development of a guideline for Trk inhibitor discontinuation.
本文旨在拓展现有关于停用Trk抑制剂后戒断性疼痛发生率的文献，并探索减轻这种戒断性疼痛的策略。
对年龄在18岁及以上、于2018年11月至2022年11月期间在加利福尼亚大学旧金山分校（UCSF）开始使用拉罗替尼或恩曲替尼且有相关记录的患者进行了一项回顾性观察研究。数据从电子记录和药房数据库中收集，本研究共纳入21例患者。
在本研究纳入的21例患者中，5例（24%）在暂时或永久停用Trk抑制剂期间出现疼痛，戒断性疼痛在停药后数小时至三天内出现。为控制这种疼痛实施了各种策略，包括重新启用Trk抑制剂、在停药时逐渐减少Trk抑制剂用量、尽量减少剂量中断以及使用处方止痛药物。
本文阐述了停用Trk抑制剂治疗的患者中存在戒断性疼痛综合征，并强调需要对患者进行教育以避免漏服任何剂量，以及制定Trk抑制剂停药指南。
