在固体瘤中使用trastuzumab deruxtecan的不良影响:系统性审查和元分析
Neha Pathak1, Massimo Di Iorio2, Diego Malon Gimenez1
1Division of Medical Oncology and Hematology, Department of Medicine, Princess Margaret Cancer Centre and University of Toronto, Toronto, ON, Canada.
Critical reviews in oncology/hematology
|June 4, 2025
概括
与化疗相比,trastuzumab deruxtecan (T-DXd) 的不良事件发生率更高,剂量,种族和癌症类型影响了安全结果. 间歇性肺病和停止治疗是关键问题.
科学领域:
- 在瘤学瘤学.
- 药理学 药理学是指药理学的学科.
- 临床试验 临床试验
背景情况:
- 特拉斯图祖马布德鲁克斯坦 (T-DXd) 是一种已批准用于各种固体瘤的疗法.
- 了解其安全性和耐受性对于临床应用至关重要.
研究的目的:
- 综合评估Trastuzumab deruxtecan (T-DXd) 的安全性和耐受性.
- 为了比较T-DXd对化疗和trastuzumab emtansine的安全性.
主要方法:
- 对MEDLINE,EMBASE和会议记录的系统文献审查.
- 来自35项研究 (48个队列) 的安全数据的元分析,包括第一,第二和第三阶段的临床试验.
- 超回归分析以确定与不良事件相关的因素.
主要成果:
- 所有等级 (97.2%) 和等级≥3 (54.9%) 的不良事件 (AE) 的高发病率.
- 最常见的副作用:恶心,疲劳,贫血. 3级以上的副作用:贫血,血小板减少,疲劳.
- 间歇性肺病 (ILD) 的发生率:13.2% (2.3%级≥3). 与治疗相关的死亡:5%.
- T-DXd与更高的副作用和停药与化疗相关.
- 剂量,非高加索种族和非乳腺癌部位与增加的副作用和死亡率有关.
结论:
- 特拉斯图祖马布德鲁克斯泰干 (T-DXd) 的安全性比传统化疗不那么好.
- 包括剂量,种族和癌症类型在内的患者因素显著影响T-DXd的安全性和耐受性.
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