分子向癌症药物和脏健康
Susan Ziolkowski1, Jin Long2, Yutong Zhong2
1Department of Medicine, Nephrology, Stanford University, Stanford, California.
JAMA network open
|November 6, 2025
概括
分子向的癌症药物可能会增加功能障碍的风险. 这项研究发现,与没有癌症的患者相比,服用这些药物的患者的发病率更高.
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:
- 口服分子向癌症药物越来越多地使用.
- 产品标签经常指出血清肌素 (sCr) 的增加,可能是由于管分泌的改变而不是急性损伤.
研究的目的:
- 确定在接受特定分子向癌症药物治疗的患者中进展性功能障碍的2年发生率和相对比率.
- 调查观察到的sCr增加是否反映了真正的损伤或处理中的可逆变化.
主要方法:
- 追溯队列研究,比较使用CDK4/6抑制剂,PARP抑制剂或特定TKI治疗的成年患者与与癌症无关的患者匹配的倾向性评分.
- 从药物开始后的1至60天计算和分析估计的淋巴细胞过率 (eGFR),以确定基线,并考虑潜在的sCr处理变化.
- 渐进性功能障碍被定义为eGFR持续下降30%或末期病的发展.
主要成果:
- 渐进性功能障碍的发生率在接受治疗的队列中较高 (每1000人年44人),与对照组相比 (每1000人年38人;HR,1.4).
- 在使用CDK4/6抑制剂,特定EGFR抑制剂,VEGFR抑制剂和BRAF抑制剂时观察到更高的发病率.
- 这种增加的风险甚至在那些在药物开始时没有显著的sCr升高,并且没有同时接受化疗或免疫治疗的患者中也存在.
结论:
- 用某些分子向抗癌药物治疗的患者面临更高的进展性功能障碍的风险.
- 这些发现强调了监测这些患者的功能的重要性,考虑到超出可逆性sCr变化的潜在药物诱导毒性.
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