Yang Ping, Zhang Hengheng, Li Jinming, Li Zitao, Liu Zhen, Wang Miaozhou, Zhao Fuxing, Zhao Jiuda, Shen GuoShuang, Zhao Yi
Qinghai University, Xining, China.
The Center of Breast Disease Diagnosis and Treatment of Affiliated Hospital of Qinghai University and Affiliated Cancer Hospital of Qinghai University, Xining, China.
Ther Adv Drug Saf. 2024 Dec 18;15:20420986241304680. doi: 10.1177/20420986241304680. eCollection 2024.
Antibody-drug conjugates (ADCs), as a new type of targeted drug, have been widely used in breast cancer patients in recent years. However, while achieving better efficacy, its hepatotoxicity should not be ignored.
To clarify the incidence of hepatotoxicity associated with ADCs and compare the incidence of hepatotoxicity of ADCs with different drugs.
We performed a systematic review and meta-analysis to summarize the clinical trials and combined the data using meta-analysis.
We searched the PubMed, Embase, and Web of Science databases up to March 12, 2023. The primary outcome was the incidence of ADC-related hepatotoxicity in breast cancer patients. The data were merged using Stata 17.0 software.
ADCs caused a high incidence of all grades of hepatotoxicity. Sacituzumab govitecan caused the highest incidence of all grades of alanine aminotransferase (ALT) elevation at 25.30% (95% confidence interval (CI): 19.29-31.82). Trastuzumab deruxtecan caused the highest incidence of all grades of aspartate aminotransferase (AST) elevation. The highest incidence of AST elevation was 31.89% (95% CI: 18.56-46.85). Conversely, trastuzumab emtansine caused the highest incidence of grade ⩾3 AST and ALT elevation (incidence rates were 3.95% (95% CI: 2.39-5.85) and 3.42% (95% CI: 1.95-5.24), respectively).
Hepatotoxicity is an adverse reaction that cannot be ignored when ADCs are used for treating breast cancer. Moreover, clinicians should pay more attention to the assessment of patients' liver function and monitoring of liver indices, particularly ALT and AST, when using ADCs.
抗体药物偶联物（ADCs）作为一种新型靶向药物，近年来已广泛应用于乳腺癌患者。然而，在取得较好疗效的同时，其肝毒性不容忽视。
明确与ADCs相关的肝毒性发生率，并比较不同药物ADCs的肝毒性发生率。
我们进行了一项系统评价和荟萃分析，以总结临床试验并使用荟萃分析合并数据。
检索截至2023年3月12日的PubMed、Embase和Web of Science数据库。主要结局是乳腺癌患者中与ADCs相关的肝毒性发生率。使用Stata 17.0软件合并数据。
ADCs导致各级肝毒性的发生率较高。戈沙妥珠单抗导致各级丙氨酸氨基转移酶（ALT）升高的发生率最高，为25.30%（95%置信区间（CI）：19.29-31.82）。德曲妥珠单抗导致各级天冬氨酸氨基转移酶（AST）升高的发生率最高。AST升高的最高发生率为31.89%（95%CI：18.56-46.85）。相反，曲妥珠单抗-美坦新导致≥3级AST和ALT升高的发生率最高（发生率分别为3.95%（95%CI：2.39-5.85）和3.42%（95%CI：1.95-5.24））。
肝毒性是ADCs用于治疗乳腺癌时不可忽视的不良反应。此外，临床医生在使用ADCs时应更加关注患者肝功能的评估和肝脏指标的监测，尤其是ALT和AST。
