| 249 | 1 | 207 |
| 下载次数 | 被引频次 | 阅读次数 |
报道1例临床药师参与的卡瑞利珠单抗致免疫相关肝损伤和甲状腺功能减退的药学实践。患者，女性，55岁，诊断为三阴性乳腺癌（化生性癌，cT4N3M1Ⅳ期，多发淋巴结、肝、肺转移）。入院后临床药师参与免疫治疗方案的制定并对治疗过程进行药学监护，建议予卡瑞利珠单抗联合阿帕替尼和艾立布林治疗，治疗后患者肿瘤较前明显缩小。第2周期治疗后患者出现食欲不佳、上腹不适，全身皮肤黄染、肝功能异常和甲状腺功能减退。排除其他原因导致的肝损伤与甲状腺功能减退，考虑与卡瑞利珠单抗有关，及时给予激素治疗并开展相关用药教育。治疗后患者上腹不适和全身皮肤黄染症状逐渐消退，肝功能指标基本恢复正常。
Abstract：[1]陆琼,吕萍.卡瑞利珠单抗对晚期三阴乳腺癌患者的影响[J].中外医学研究, 2023, 21(30):21.
[2]郑飞跃,吴燕,饶跃峰,等.诺氏评估量表在药物不良反应评价中的作用及实例分析[J].中国药学杂志, 2012, 47(8):650.
[3]中国临床肿瘤学会指南工作委员会组织.中国临床肿瘤学会(CSCO)免疫检查点抑制剂相关的毒性管理指南[M].北京:人民卫生出版社, 2021.
[4] PEERAPHATDIT T B, WANG J, ODENWALD M A, et al.Hepatotoxicity from immune checkpoint inhibitors:a systematic review and management recommendation[J]. Hepatol Baltim Md, 2020, 72(1):315.
[5] CORTES J, CESCON D W, RUGO H S, et al. Pembrolizumab plus chemotherapy versus placebo plus chemotherapy for previously untreated locally recurrent inoperable or metastatic triple-negative breast cancer(KEYNOTE-355):a randomised, placebo-controlled,double-blind, phase 3 clinical trial. Lancet. 2020, 396(10265):1817.
[6] JIANG Z F, OUYANG Q C, SUN T, et al. Toripalimab plus nabpaclitaxel in metastatic or recurrent triple-negative breast cancer:a randomized phase 3 trial[J]. Nat Med, 2024, 30(1):249.
[7] LIU J Q, WANG Y, TIAN Z L, et al. Multicenter phaseⅡtrial of Camrelizumab combined with Apatinib and Eribulin in heavily pretreated patients with advanced triple-negative breast cancer[J].Nat Commun, 2022, 13(1):3011.
[8] LIU J Q, LIU Q, LI Y, et al. Efficacy and safety of camrelizumab combined with apatinib in advanced triple-negative breast cancer:an open-label phase II trial[J]. J Immunother Cancer, 2020,8(1):e000696.
[9] ZHANG W, HE Y, TANG Y, et al. A Meta-analysis of application of PD-1/PD-L1 inhibitor-based immunotherapy in unresectable locally advanced triple-negative breast cancer. Immunotherapy.2023, 15(13):1073.
[10] MIZUNO K, ITO T, ISHIGAMI M, et al. Real world data of liver injury induced by immune checkpoint inhibitors in Japanese patients with advanced malignancies[J]. J Gastroenterol, 2020,55(6):653.
[11] PEERAPHATDIT T B, WANG J, ODENWALD M A, et al.Hepatotoxicity from immune checkpoint inhibitors:a systematic review and management recommendation[J]. Hepatol Baltim Md, 2020, 72(1):315.
[12] AHN M J, SUN J M, LEE S H, et al. EGFR TKI combination with immunotherapy in non-small cell lung cancer[J]. Expert Opin Drug Saf, 2017, 16(4):465.
[13] DAVIES M, DUFFIELD E A. Safety of checkpoint inhibitors for cancer treatment:strategies for patient monitoring and management of immune-mediated adverse events[J]. Immunotargets Ther,2017, 6:51.
[14] FREITES-MARTINEZ A, SANTANA N, ARIAS-SANTIAGO S,et al. Using the common terminology criteria for adverse events(CTCAE-version 5.0)to evaluate the severity of adverse events of anticancer therapies[J]. Actas Dermosifiliogr, 2021, 112(1):90.
[15]中华医学会内分泌学分会,中国内分泌代谢病专科联盟.糖皮质激素类药物临床应用指导原则(2023版)[J].中华内分泌代谢杂志, 2023, 39(4):289.
基本信息:
DOI：10.19577/j.1007-4406.2024.11.012
中图分类号:R979.1
引用信息:
[1]李剑屏,李安娜,杜宁,等.1例卡瑞利珠单抗致免疫相关不良反应的药学实践[J].中国临床药学杂志,2024,33(11):859-862.DOI:10.19577/j.1007-4406.2024.11.012.
2024-11-25
2024-11-25