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[恩杂鲁胺治疗尿路上皮癌相关皮肤症状的危险因素]

[Risk Factor of Cutaneous Symptoms Associated with Enfortumab Vedotin for Urothelial Carcinoma].

作者信息

Honda Hiroyuki, Matsuo Tomohiro, Mori Shintaro, Araki Kyohei, Mitsunari Kensuke, Ohba Kojiro, Mochizuki Yasushi, Imamura Ryoichi

机构信息

The Department of Urology and Renal Transplant Surgery, Faculty of Medicine, University of Nagasaki.

出版信息

Hinyokika Kiyo. 2024 Nov;70(11):361-366. doi: 10.14989/ActaUrolJap_70_11_361.

Abstract

In 2021, Enfortumab Vedotin (EV) was approved for the treatment of locally advanced and metastatic urothelial carcinoma (UC) in Japan. Some patients require withdrawal or dose reduction due to cutaneous symptoms associated with EV treatment. Currently, the only reported associations of EV with cutaneous symptoms are pre-treatment performance status (PS) and body weight. However, no report has focused on the association between hematological factors and cutaneous symptoms. We retrospectively examined the occurrence of cutaneous symptoms and associated factors in patients who had been treated with EV for UC at Nagasaki University Hospital between February 2022 and June 2023. We evaluated the six patients with bladder cancer and three cases of upper urinary tract cancer. The median age was 73 [57-85] years. Seven patients had cutaneous reactions with EV treatment, and the median date of onset of the cutaneous symptoms was seven [4 -28] days. PS was better inthe group with skinsymptoms compared with the group without (median : 1.0 vs 3.0), and in those with a higher incidence of eosinophilia or cutaneous symptoms on the previous regimen (71. 4% vs 0%). We suggested that the presence of eosinophilia or cutaneous symptoms at the time of pre-EV regimen administration may be a predictor of the appearance of cutaneous symptoms at the time of EV treatment. The limitation is that it is a single-center, small-case series, which does not allow for a rigorous statistical study.

摘要

2021年,安维汀(Enfortumab Vedotin,EV)在日本被批准用于治疗局部晚期和转移性尿路上皮癌(UC)。一些患者因与EV治疗相关的皮肤症状而需要停药或减量。目前,唯一报道的与EV相关的皮肤症状的关联因素是治疗前的体能状态(PS)和体重。然而,尚无关于血液学因素与皮肤症状之间关联的报道。我们回顾性研究了2022年2月至2023年6月在长崎大学医院接受EV治疗UC的患者中皮肤症状的发生情况及相关因素。我们评估了6例膀胱癌患者和3例上尿路癌患者。中位年龄为73[57 - 85]岁。7例患者在EV治疗时有皮肤反应,皮肤症状的中位发病时间为7[4 - 28]天。有皮肤症状的组与无皮肤症状的组相比,PS更好(中位值:1.0对3.0),并且在前一治疗方案中嗜酸性粒细胞增多或皮肤症状发生率较高的患者中(71.4%对0%)。我们认为在EV治疗前方案给药时存在嗜酸性粒细胞增多或皮肤症状可能是EV治疗时出现皮肤症状的一个预测指标。局限性在于这是一个单中心、小病例系列研究,无法进行严格的统计学研究。

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