Лечение нежелательных явлений, ассоциированных с приемом ленватиниба, у пациентов с радиойодрефрактерным дифференцированным раком щитовидной железы
https://doi.org/10.17650/2222-1468-2019-9-4-49-61
Аннотация
Ленватиниб – мультикиназный ингибитор рецепторов к фактору роста эндотелия сосудов (vascular endothelial growth factor, VEGF) 1–3, фактору роста фибробластов 1–4, тромбоцитарному фактору роста α, а также протоонкогенов RET и KIT. Ленватиниб был одобрен в качестве препарата для монотерапии радиойодрефрактерного дифференцированного рака щитовидной железы, а также (в комбинации с эверолимусом) как препарат 2-й линии для терапии прогрессирующего почечно-клеточного рака. Кроме того, сейчас проводятся исследования эффективности ленватиниба в отношении нескольких типов злокачественных новообразований, включая неоперабельный гепатоцеллюлярный рак. Несмотря на то что ленватиниб имеет высокую эффективность, при его применении могут развиваться неблагоприятные явления (НЯ), которые необходимо тщательно контролировать и активно лечить. Большинство из этих НЯ свойственны всем анти-VEGF-препаратам. Это артериальная гипертензия, диарея, повышенная утомляемость или астения, снижение аппетита и массы тела. В данном обзоре обобщены сведения о безопасности ленватиниба и представлены рекомендации по лечению как частых, так и редких НЯ. Обсуждаются потенциальные механизмы, лежащие в основе этих НЯ, и предлагаются рекомендации по уменьшению выраженности токсических эффектов. Разработка плана лечения, включающего стратегии профилактики и терапии НЯ, ассоциированных с приемом ленватиниба, позволит улучшить качество жизни пациентов, повысить их приверженность к лечению, уменьшить необходимость в снижении дозы, временной или полной отмене препарата, а также обеспечить наилучшие исходы лечения.
Ключевые слова
нежелательные явления,
дифференцированный рак щитовидной железы,
ленватиниб,
побочные эффекты,
ингибиторы тирозинкиназы
При поддержке: Работа поддержана Eisai Inc. (Нью-Джерси, США). Oxford PharmaGenesis Inc. (Ньютаун, Пенсильвания, США) финансировала редакционную подготовку первоначального (англоязычного) варианта статьи. Русский перевод статьи подготовлен и выпущен при финансовой поддержке ООО «Эйсай».
Об авторах
M. E. Cabanillas
The University of Texas M.D. Anderson Cancer Center
Соединённые Штаты Америки
Соединённые Штаты Америки
S. Takahashi
Japanese Foundation for Cancer Research
Япония
Япония
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Рецензия
Для цитирования:
Cabanillas M.E., Takahashi S. Лечение нежелательных явлений, ассоциированных с приемом ленватиниба, у пациентов с радиойодрефрактерным дифференцированным раком щитовидной железы. Опухоли головы и шеи. 2019;9(4):49-61. https://doi.org/10.17650/2222-1468-2019-9-4-49-61
For citation:
Cabanillas M.E., Takahashi S. Managing the adverse events associated with lenvatinib therapy in radioiodine-refractory differentiated thyroid cancer. Head and Neck Tumors (HNT). 2019;9(4):49-61. (In Russ.) https://doi.org/10.17650/2222-1468-2019-9-4-49-61
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