在接受CDK4/6抑制剂的患者中伪急性损伤
Sanne M Buijs1, Elisabeth M Jongbloed2, Lotte E M van Bergen2
1Department of Medical Oncology, Erasmus MC Cancer Institute, Rotterdam, the Netherlands. s.buijs@erasmusmc.nl.
British journal of cancer
|February 10, 2025
概括
循环素依赖性激酶4/6抑制剂 (CDK4/6i) 通过影响肌素水平,可以导致伪急性损伤 (伪AKI). 测量囊素C对于在接受CDK4/6i治疗的患者中准确评估功能至关重要.
科学领域:
- 在瘤学瘤学.
- 腎臟病學 (nephrology) 是一種醫學專業.
- 药理学 药理学是指药理学的学科.
背景情况:
- 循环素依赖性激酶4/6抑制剂 (CDK4/6i) 是晚期ER阳性乳腺癌的标准治疗方法,改善了无进展的生存率.
- CDK4/6i可以提高血清肌素,可能表明损伤,但也可能抑制管状肌素分泌,导致伪急性损伤 (伪AKI).
- 在接受CDK4/6i的患者中,伪AKI的发生率和临床意义尚未得到充分确立.
研究的目的:
- 确定用CDK4/6i治疗的乳腺癌患者中伪AKI的发生率.
- 评估囊素C测量的实用性,以区分真实AKI与伪AKI.
- 评估误诊的伪AKI对治疗管理的影响.
主要方法:
- 在2017年1月至2023年12月期间,对接受CDK4/6i治疗的乳腺癌患者进行了回顾性单中心队列研究.
- 在治疗的前六个月内,使用定义的标准对肌素增加的查表明AKI.
- 伪AKI的诊断基于估计的淋巴细胞过率 (eGFR) 计算,使用基因和基因基因基因基因基因基因基因基因基因基因基因基因基因基因基因基因基因基因基因基因基因基因基因基因基因基因基因基因基因基因基因基因基因基因基因基因基因基因基因基因基因基因基因基因基因基因基因基因基因基因基因基因基因基因基因基因基因基因基因基因基因基因基因基因基因基因基因基因基因基因基因基因基因基因基因基因基因基因基因基因基因基因基因基因基因基因基因基因基因基因基因基因基因基因基因基因基因基因基因基因基因基因基因基因基因基因基因基因基因基因基因基因基因基因基因基因
主要成果:
- 在接受CDK4/6i治疗的234名患者中,41人 (17.5%) 呈现出具有AKI的肌素水平.
- 其中22名患者可获得血清囊素C;16名患者 (73%,95%CI50-89%) 发现了伪AKI.
- 在5名患者 (12%),CDK4/6i剂量进行了不适当的调整,或由于肌素升高而没有真正的损伤而中止治疗.
结论:
- 伪AKI在接受CDK4/6i治疗的患者中是常见的,在这个队列中观察到的高发病率.
- 使用cystatin C测量eGFR应被视为最初的诊断步骤,当肌素水平在CDK4/6i治疗期间上升.
- 准确区分真实AKI和伪AKI至关重要,以防止不必要的治疗修改.
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