2023年更新的MASCC/ESMO共识建议:在中度吐风险抗瘤剂后预防恶心和吐
Florian Scotté1, Lee Schwartzberg2, Hirotoshi Iihara3
1Interdisciplinary Patient Pathway Division, Gustave Roussy, 114 Rue Edouard Vaillant, 94800, Villejuif, France. florian.scotte@gustaveroussy.fr.
更新的指导方针建议针对特定的中度的潜在癌症治疗进行三重抗疗法. 对于中度发泄性化疗,应将类固醇限制在第一天,以优化支持性护理.
科学领域:
- 在瘤学瘤学.
- 药理学 药理学是指药理学的学科.
- 基于证据的医学 基于证据的医学
背景情况:
- 恶心和吐是癌症治疗的重要副作用.
- 现有的管理化疗诱导的恶心和吐 (CINV) 的指导方针需要根据最近的证据进行更新.
研究的目的:
- 审查文献并更新跨国癌症支持护理协会 (MASCC) 关于控制与中度吐潜力的全身癌症治疗相关的恶心和吐的指导方针.
- 将新的证据和改变实践的建议纳入现有指南中.
主要方法:
- 使用Medline,Embase和Scopus数据库进行了系统的文献审查.
- 搜索的重点是适度潜力的抗癌疗法的抗性预防,涵盖了2015年6月至2023年1月的出版物.
- 从342篇最初的文章中,确定了19篇相关论文.
主要成果:
- 在50岁以下的女性中,建议对卡博普拉丁 (AUC ≥ 5) 和基于牛氧的治疗进行三重抗emetic预防 (神经素-1受体对抗剂,5-HT3受体对抗剂和类固醇).
- 双重组合 (5-HT3受体抗剂和类固醇) 仍然是其他中度发性化疗 (MEC) 的标准.
- 在MEC疗法中,由于已证明非劣质性,应将类固醇的使用限制在第一天.
结论:
- 更新的MASCC-ESMO指南包括个人风险因素和优化的抗治疗方法.
- 需要进一步研究新药的 emetogenicity 如sacituzumab-govitecan 和 trastuzumab-deruxtecan.
- 未来的研究应该包括与患者相关的风险评估,以改善MEC指南.
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