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正确识别和治疗靶向治疗药所致皮肤不良反应

2009-05-16 23:22:51  作者:新特药房  来源:新特药房药讯  浏览次数:38  文字大小:【】【】【
简介:表皮生长因子受体抑制剂西妥昔单抗或厄洛替尼,越来越多地被用于治疗实体肿瘤,由此,导致一些新的继发性不良反应的出现。西班牙巴塞罗那学者Roe等进行的一项前瞻性研究显示,西妥昔单抗或厄洛替尼较少引起诸如 ...
表皮生长因子受体抑制剂西妥昔单抗或厄洛替尼,越来越多地被用于治疗实体肿瘤,由此,导致一些新的继发性不良反应的出现。西班牙巴塞罗那学者Roe等进行的一项前瞻性研究显示,西妥昔单抗或厄洛替尼较少引起诸如骨髓抑制、神经病变、恶心呕吐和脱发等全身不良反应,但皮肤不良反应的发生率较高。
 
 研究者观察了接受西妥昔单抗或厄洛替尼治疗的30例Ⅲ期结直肠癌或肺癌患者,以确定皮肤不良反应的类型、发生率以及进展情况。
 
 结果显示,大多数患者出现痤疮样的滤泡疹,主要分布于躯干、面部、颈部和头皮,以用药15天内在皮脂溢出部位出现为特征表现,发生率在西妥昔单抗或厄洛替尼用药者中分别为82%和60%。第2种常见的皮肤毒性是掌、趾处出现有痛感的龟裂和甲沟炎。此外,在随访数月后,患者的毛发生长出现异常,一些病例出现睫毛异常生长或头发生长速度减慢。
 
 对这些不良反应抗痤疮药、局部抗生素以及抗炎药物有良好的治疗效果,因此,很少有患者因皮肤毒性而停用抗肿瘤药物。
 
 研究者认为,正确识别和治疗因靶向治疗药物诱发的皮疹有助于改善癌症患者的生活质量,从而提高其抗肿瘤治疗的依从性,延长生存期。
 
J Am Acad Dermatol. 2006 Sep;55(3):429-37.
 
Description and management of cutaneous side effects during cetuximab or erlotinib treatments: a prospective study of 30 patients.
 
Roe E, Garcia Muret MP, Marcuello E, Capdevila J, Pallares C, Alomar A.
 
Department of Dermatology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.
 
BACKGROUND: Drugs such as cetuximab or erlotinib, which inhibit the epidermal growth factor receptor, are increasingly being used in treatment of solid tumors. This has led to the appearance of new secondary effects. OBJECTIVE: We sought to describe the cutaneous side effects and their management in patients with cancer treated with cetuximab or erlotinib. METHODS: We clinically examined 30 patients determining type, frequency, treatment, and evolution of side effects. RESULTS: Most patients presented with a cutaneous reaction consisting of a follicular eruption, typically appearing in seborrheic areas within the first 15 days of treatment. Painful fissures in palms and soles and paronychia were the second most common cutaneous toxicities. We also noticed an alteration in hair growth at several months'' follow-up. As these secondary effects responded well to treatment, few patients discontinued the antineoplastic therapy because of cutaneous toxicity. LIMITATIONS: This was a prospective but uncontrolled study. CONCLUSION: Although these new targeted therapies have low systemic toxicity because of their high specificity, cutaneous side effects are common and may be serious.
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121790 特罗凯 盐酸厄洛替尼片 Schwarz Pharma Manufacturing Inc. 150mg*30片 18500
*声明:以上价格仅作参考,实际价格以药房各分店为准。

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