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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

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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.

Об авторах

M. E. Cabanillas
The University of Texas M.D. Anderson Cancer Center
Соединённые Штаты Америки


S. Takahashi
Japanese Foundation for Cancer Research
Япония


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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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