[新型分子向瘤药物的脏副作用]
Roberta Fenoglio1, Simone Cortazzi1, Martina Marchisio1
1University Center of Excellence on Nephrological, Rheumatological and Rare Diseases (ERK-net, ERN-Reconnect and RITA-ERN Member) including Nephrology and Dialysis Unit and Center of Immuno-Rheumatology and Rare Diseases (CMID), Coordinating Center of the Interregional Network for Rare Diseases of Piedmont and Aosta Valley (North-West Italy), San Giovanni Bosco Hub Hospital, ASL Città di Torino and Department of Clinical and Biological Sciences of the University of Turin, Turin, Italy.
脏活检对于识别免疫疗法和抗血管生成疗法等癌症疗法造成的脏损伤至关重要. 组织学指导治疗决策,通常允许继续免疫疗法 (ICI) 和向疗法.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 在瘤学瘤学.
- 病理学 病理学 病理学
背景情况:
- 创新的癌症疗法 (免疫疗法,向疗法) 可能会导致脏不良影响.
- 由于研究的局限性和患者排除,延迟认知毒性是常见的.
- 病显著影响癌症患者的管理和治疗坚持.
研究的目的:
- 检查使用新型药物治疗的癌症患者损伤的组织学特征.
- 评估活检在治疗诱导的毒性管理中的作用.
- 将组织学发现与特定疗法相关联,并指导治疗决策.
主要方法:
- 对42名癌症患者进行脏活检以检测新发功能衰竭或尿路异常的回顾性分析.
- 用免疫疗法 (54.8%) 和抗血管原剂 (45.2%) 治疗的患者组织学发现的综述.
- 活检结果与临床结果和治疗管理的相关性.
主要成果:
- 管间炎在免疫疗法 (ICI) 时很常见,而血栓性微血管病变 (TMA) 在抗血管原剂 (抗VEGF) 时很常见.
- 组织学证实,在需要终止治疗的患者中,抗VEGF相关的TMA.
- 对于ICI诱导的损伤,停止治疗通常是不必要的;在多药疗程中,组织学澄清了药物特异性损伤.
结论:
- 脏活检对于准确诊断和管理新型癌症代理诱导的毒性至关重要.
- 组织学发现有助于个性化治疗策略,区分疗法并指导停药决策.
- 在免疫疗法或向治疗期间,考虑对癌症患者进行脏活检,这些患者有尿路异常或功能下降.
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