在三个患有胃肠道切除的癌症患者中,帕佐帕尼布的药理学指导剂量优化
Cléa Tardy1, Alicja Puszkiel2,3, Pascaline Boudou-Rouquette4
1Pharmacy Department, Cochin Hospital (AP-HP), CARPEM, Paris, France. clea.tardy@aphp.fr.
Cancer chemotherapy and pharmacology
|August 24, 2023
概括
在患有胃肠切除 (GIR) 的患者中,由于药物暴露不良,帕佐帕尼布剂量升级是不可行的. 建议使用替代疗法和治疗前评估来管理这些癌症患者.
科学领域:
- 药理学 药理学是指药理学的学科.
- 在瘤学瘤学.
- 胃肠病学 胃肠病学
背景情况:
- 帕佐帕尼布已被批准用于晚期细胞癌 (RCC) 和软组织肉瘤.
- 标准剂量具有很高的个体间变异性和狭窄的治疗指数.
- 在胃肠切除 (GIR) 患者中,帕佐帕尼布的药理动力学还没有得到充分描述.
研究的目的:
- 评估GIR患者在药理学指导下的帕佐帕尼布剂量升级的可行性.
- 评估帕佐帕尼布暴露在该患者群体中的临床影响.
主要方法:
- 从三名用帕佐帕尼布治疗的GIR患者回顾性数据收集.
- 使用具有紫外线检测的高性能液体染色学测量帕佐帕尼布的血度.
- 使用吉雷德评分评估治疗坚持.
主要成果:
- 第一个患者 (RCC,胃绕道) 在剂量升级到1800毫克/天后实现了次优Cmin,ss (18.5毫克/升).
- 第二组 (myxofibrosarcoma,胃带) 和第三组 (胃瘤,胃切除术) 患者表现出明显的低Cmin,ss (4.0 mg/L和2.7 mg/L,分别) 即使在剂量调整后.
- 治疗药物监测表明,这些患者无法达到最佳的帕佐帕尼布暴露.
结论:
- 在GIR患者中,巴佐帕尼布的最佳暴露不太可能.
- 治疗前评估诸如减肥手术等因素至关重要.
- 替代治疗策略和治疗药物监测可能是管理这些患者的必要条件.
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