肝功能障碍:对帕克利塔塞尔毒性,剂量修改和整体存活时间的影响
Marieke Schmidt1, Robin Vernooij2,3,4, Merel van Nuland1
1Department of Clinical Pharmacy, University Medical Center Utrecht, PO Box 85500, Utrecht, 3508 GA, The Netherlands.
BMC cancer
|December 19, 2024
概括
肝功能受损会增加严重血液毒性的风险,并降低治疗晚期乳腺癌,卵巢癌或食道癌的帕克利塔塞尔患者的整体存活率 (OS). 剂量修改应仔细考虑.
科学领域:
- 在瘤学瘤学.
- 药理学 药理学是指药理学的学科.
- 肝病学 肝病学是一种肝病学.
背景情况:
- 帕克利塔塞尔是一种关键的抗癌药物,主要由肝脏代谢.
- 肝功能受损与帕克利塔塞尔毒性增加有关,这表明潜在的剂量调整.
- 有限的证据需要进一步调查肝功能对帕克利塔塞尔治疗结果的影响.
研究的目的:
- 为了研究肝功能障碍对帕克利塔克塞尔诱导的血液毒性的影响.
- 为了评估肝功能受损对用帕克利塔塞尔治疗的癌症患者剂量修改和整体存活时间 (OS) 的影响.
- 为了比较正常和肝功能受损的患者之间的毒性风险.
主要方法:
- 一个单一中心的回顾性观察性研究,涉及569名患者接受乳腺,食道或卵巢癌的帕克利塔塞尔治疗.
- 使用NCI标准评估胆红素和ASAT (阿斯巴酸胺转移酶) 度的肝功能.
- 使用回归分析来比较3/4级血液毒性,剂量修改和正常肝功能和肝功能受损的患者之间的OS风险.
主要成果:
- 肝功能轻微受损的患者 (乳腺癌,高级治疗) 患中性质减退3/4级 (HR=4.39) 的风险更高.
- 肝功能受损与晚期卵巢癌中3/4级白血病 (HR=12.64) 和剂量修改 (HR=3.91) 的增加有关.
- 在接受治疗的肝功能受损患者中观察到下降的OS,这些患者接受了不可手术的食道癌 (HR=7.65) 和晚期卵巢癌 (HR=2.98) 的治疗.
结论:
- 肝功能受损增加了血液毒性的风险,在先进的乳腺癌和卵巢癌患者治疗帕克利塔塞尔.
- 肝功能受损与晚期卵巢癌和不可手术的食道癌患者的生存系统减少有关.
- 在前期剂量修改和适应性策略之间保持谨慎的平衡对于在肝功能受损的患者中管理帕克利塔塞尔治疗至关重要.
相关概念视频
Drugs that Stabilize Microtubules
2.0K
Microtubules are dynamic structures that undergo cycles of catastrophe and rescue. The microtubules play a central role in cell division by forming the spindle apparatus for segregating the chromosomes. This makes them ideal targets for regulating dividing cells in tumors and malignant cancer cells. Microtubule stabilizing drugs help stabilize the microtubule formation and promote its polymerization. Paclitaxel was the first microtubule stabilizing agent used as anticancer drug in chemotherapy...
2.0K
Nonlinear Pharmacokinetics: Dependence of Elimination Half-Life and Dose Clearance
80
The elimination half-life and drug clearance of drugs following nonlinear kinetics can vary with dosage. The Michaelis-Menten parameters and drug concentration influence these factors. As the dose increases, the elimination half-life tends to lengthen, resulting in a reduction in clearance and a disproportionately larger area under the curve. The total clearance can be derived from the Michaelis-Menten equation for drugs following a one-compartment model.
A study on guinea pigs examined the...
A study on guinea pigs examined the...
80
Combination Therapies and Personalized Medicine
4.8K
Combining two or more treatment methods increases the life span of cancer patients while reducing damage to vital organs or tissue from the overuse of a single treatment. Combination therapy also targets different cancer-inducing pathways, thus reducing the chances of developing resistance to treatment.
The combination of the drug acetazolamide and sulforaphane is a good example of combination therapy to treat cancer. The cells in the interior of a large tumor often die due to the hypoxic and...
The combination of the drug acetazolamide and sulforaphane is a good example of combination therapy to treat cancer. The cells in the interior of a large tumor often die due to the hypoxic and...
4.8K
Tissue-Drug Binding: Localization of Drugs and its Significance
62
Body tissues, comprising approximately 40% of the body weight, are crucial in drug distribution and localization. These tissues can serve as drug storage sites, competing with plasma binding sites for drug molecules.
Drugs can bind to different tissue components, enhancing their distribution and localization. The factors influencing drug localization in tissues include the drug's lipophilicity, structural characteristics, tissue perfusion rate, and pH differences. These factors determine...
Drugs can bind to different tissue components, enhancing their distribution and localization. The factors influencing drug localization in tissues include the drug's lipophilicity, structural characteristics, tissue perfusion rate, and pH differences. These factors determine...
62
Renal Failure: Dose Adjustments
63
In patients with renal impairment, drugs undergo significant changes in their pharmacokinetics, which require dosage adjustments to ensure safe and effective therapy.
Reduced renal clearance and elimination rate are common outcomes of renal impairment. These alterations lead to a prolonged elimination half-life and an altered apparent volume of distribution for drugs. As a result, dosage adjustments are typically necessary to maintain optimal drug levels in the body.
However, dosage adjustments...
Reduced renal clearance and elimination rate are common outcomes of renal impairment. These alterations lead to a prolonged elimination half-life and an altered apparent volume of distribution for drugs. As a result, dosage adjustments are typically necessary to maintain optimal drug levels in the body.
However, dosage adjustments...
63
Factors Influencing Drug Absorption: Disease States and Pharmacology
428
Multiple disease states can significantly influence the oral drug absorption process by affecting blood flow and the functionality of the gastrointestinal (GI) system. Various GI diseases, including conditions that alter GI motility, such as diarrhea, decreased acid secretions (achlorhydria), and infections, have been associated with reduced drug absorption.
Substances such as alcohol and specific drugs, including antineoplastics, can also negatively impact drug absorption. For instance,...
Substances such as alcohol and specific drugs, including antineoplastics, can also negatively impact drug absorption. For instance,...
428


