抗体-药物结合物:急诊医生必须知道的毒性和副作用
Danna Michelle Markides1, Angel Guido Hita1, Jeffrey Merlin1
1Department of Emergency Medicine, MD Anderson Cancer Center, Houston, TX.
Annals of emergency medicine
|December 6, 2024
概括
抗体-药物合物 (ADC) 正在扩大癌症治疗的范围. 本综述详细介绍了它们的毒性和紧急管理,包括罕见但严重的疾病,如间歇性肺病和肝功能障碍.
科学领域:
- 在瘤学瘤学.
- 药理学 药理学是指药理学的学科.
- 毒理学 毒理学 毒理学
背景情况:
- 抗体-药物合物 (ADC) 是癌症治疗的重大进展.
- 它们的临床应用正在迅速增加,需要全面了解它们的相关毒性.
- 与ADC相关的不良事件的紧急呈现和管理需要特别的临床关注.
研究的目的:
- 审查FDA批准的抗体-药物合物用于癌症治疗的已知毒性和并发症.
- 专注于这些不良事件的紧急呈现和管理策略.
- 突出与单个ADC相关的特定毒性及其临床影响.
主要方法:
- 在美国批准的抗体-药物联合体的文献综述.
- 分析报告的毒性,重点关注紧急情况.
- 针对已识别的并发症,对当前应急管理协议的总结.
主要成果:
- 常见的毒性包括腹,恶心,皮疹,神经病变和细胞衰竭,使用标准护理进行管理.
- 严重的不良事件包括间歇性肺病 (特拉斯图祖马布德鲁克斯泰坎,米尔韦图祖马布索拉夫坦辛),侧侧阻塞综合征 (伊诺图祖马布奥佐加米辛,吉姆图祖马布奥佐加米辛),心脏功能障碍,眼睛毒性和渐进的多焦点白内障.
- 其他潜在的紧急情况包括瘤溶解综合征,高血糖症,出血事件和过敏反应.
结论:
- 抗体与药物结合剂虽然有效,但具有一系列的毒性,需要谨慎监测和及时应急管理.
- 特定的ADC与独特且可能危及生命的并发症有关,例如间歇性肺病和侧腔阻塞综合征.
- 进一步的研究至关重要,以阐明罕见并发症的现实发病率,并优化急诊室对ADC相关不良事件的准备.
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