皮质类固醇用于管理TRK抑制剂戒断疼痛:两例病例的报告
Nicolas Marcoux1, Louis-Philippe Grenier2
1Medical Oncology, Centre Hospitalier Universitaire de Québec Université Laval, Québec, QC G1V 0A6, Canada.
Current oncology (Toronto, Ont.)
|February 26, 2026
概括
TRK 抑制剂戒断疼痛可以有效地通过短时间的皮质类固醇治疗来管理,当逐渐减少是不可行的. 这种方法为停止向治疗后经历衰弱性疼痛的患者提供了持久的缓解.
科学领域:
- 在瘤学瘤学.
- 神经科学是一个神经科学.
- 药理学 药理学是指药理学的学科.
背景情况:
- 神经营养素受体氨酸激酶 (NTRK) 融合是各种固体瘤中关键的致癌驱动因素.
- NTRK抑制剂 (拉罗特雷克提尼布,恩特雷克提尼布,雷波特雷克提尼布) 向这些融合.
- 通过NTRK抑制剂破坏神经生长因子 (NGF) 信号传递可能会影响 nociception,导致戒断疼痛.
研究的目的:
- 在停止TRK抑制剂治疗后,报告了两起衰弱性戒断疼痛病例.
- 评估皮质类固醇在治疗TRK抑制剂戒断疼痛方面的疗效.
主要方法:
- 两名患有NTRK融合阳性固体瘤的男性患者分别接受了repotrectinib和larotrectinib治疗,在药物停止后经历了严重的疼痛.
- 标准止痛药失败了;短时间的普雷迪尼松和德克萨米他松疗程被管理.
- 在类固醇治疗后,监测疼痛复发和功能状态.
主要成果:
- 两位患者在24小时内经历了显著的疼痛缓解.
- 在停止使用类固醇后,疼痛不会复发.
- 患者表现出改善的功能状态,没有显著的不良事件.
结论:
- 短期的皮质类固醇治疗可以为TRK抑制剂戒断疼痛提供持久的缓解,当逐渐减少不是一种选择时.
- 这些发现凸显了进一步研究NTRK,NGF和 nociception之间的机制的需要.
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