药物暴露和单核酸多形态对固体瘤中阿帕丁尼布诱导的严重毒性的影响
Youhao Chen1, Yaobin Lin1, Shaoxing Guan1
1Institute of Clinical Pharmacology, School of Pharmaceutical Sciences, Sun Yat-Sen University, Guangzhou, China (Y.C., S.G., M.H., X.W.); Departments of Thoracic Oncology (Y.L., Z.Z., H.L.) and Medical Oncology (J.L., L.C.), State Key Laboratory of Oncology in South China, Sun Yat-sen University Cancer Center, Guangzhou, China; Departments of Medical Oncology (D.L.), Thoracic Surgery (Z.L.), and Gynecology (W.Z.), Jiangmen Central Hospital, Jiangmen, China; Department of Oncology, People's Hospital of Jiangmen, Jiangmen, China (J.G.); Department of Medical Pneumology, First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China (C.Z.); Department of Medical Oncology, Guangzhou Panyu Central Hospital, Guangzhou, China (X.C.); Department of Targeted Interventional Oncology, First Hospital of Foshan, Foshan, China (D.C.); Department of Oncology, Wuyi Hospital of Traditional Chinese Medicine, Jiangmen, China (J.S.); Department of Medical Oncology, The Second People's Hospital of Zhaoqing, Zhaoqing, China (H.C.); Department of Oncology, Nanfang Hospital, Southern Medical University, Guangzhou, China (S.M.); Department of Cardio-thoracic Surgery, Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China (L.G.); and Department of Thoracic Surgery, Affiliated Cancer Hospital and Institute of Guangzhou Medical University, Guangzhou, China (J.Z.).
药物暴露和遗传因素预测非小细胞肺癌 (NSCLC) 患者的阿帕蒂尼布毒性. 监测药物水平和特定基因变异 (CYP2C9) 可以帮助管理严重的不良事件.
科学领域:
- 药物基因组学 药物基因组学
- 在瘤学瘤学.
- 药物新陈代谢 药物新陈代谢
背景情况:
- 阿帕丁尼布 (APA) 是一种抗VEGFR2抑制剂,可治疗各种癌症,但会引起显著的毒性.
- 关于药物暴露和遗传因素如何影响阿帕蒂尼布诱导毒性的数据有限.
- 了解这些因素对于临床监测和管理不良事件至关重要.
研究的目的:
- 调查药物暴露和生殖系遗传因素对阿帕蒂尼布相关毒性的预测价值.
- 为了确定与阿帕蒂尼布治疗相关的严重不良事件的潜在生物标志物.
主要方法:
- 对126名晚期固体瘤患者进行前性研究,每天接受250毫克阿帕蒂尼布.
- 通过液体染色学-并联质谱法量化血apatinib和代谢物M1-1度.
- 57个生殖基因突变的基因定型,包括CYP2C9变异,以及与毒性概况的相关性分析.
主要成果:
- 非小细胞肺癌 (NSCLC) 患者对阿帕蒂尼布毒性的敏感性更高.
- 在NSCLC中,阿帕蒂尼布及其代谢物M1-1的血度升高与高度不良事件和抗血管遗传毒性相关.
- 特定的CYP2C9基因型 (rs34532201 TT和rs1936968 GG) 与更高的药物和代谢物水平有关.
结论:
- 血阿帕蒂尼布和M1-1暴露水平可以预测NSCLC患者的严重不良事件.
- 建议对具有特定CYP2C9基因型的NSCLC患者进行剂量优化和药物暴露监测.
- 药物暴露和单核酸多态性作为阿帕蒂尼布诱导的严重毒性的有价值的预测生物标志物.
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