洛拉替尼特殊不良反应管理中国专家共识  

Chinese Expert Consensus on Management of Special Adverse Effects Associated with Lorlatinib

作　　者：周清[1] 陆舜[2] 李勇 贾福军 李冠军[5] 洪震 卢铀[7] 范云[8] 周建英 刘喆[10] 李娟[11] 吴一龙[1] 中国胸部肿瘤研究协作组 洛拉替尼特殊不良反应管理中国专家共识工作组 Qing ZHOU;Shun LU;Yong LI;Fujun JIA;Guanjun LI;Zhen HONG;You LU;Yun FAN;Jianying ZHOU;Zhe LIU;Juan LI;Yi-Long WU;Chinese Thoracic Oncology Group(CTONG);Chinese Expert Consensus on Management of Special Adverse Effects Associated with Lorlatinib Workgroup(Guangdong Lung Cancer Institute,Guangdong Provincial People's Hospital,Guangdong Academy of Medical Sciences,Guangzhou 510080,China;Department of Oncology,Shanghai Chest Hospital,Shanghai Jiao Tong University,Shanghai 200030,China;Department of Cardiology,Huashan Hospital,Fudan University,Shanghai 200040,China;Department of Psychiatry,Guangdong Mental Health Center,Guangzhou 510120,China;Department of Psychiatry,Shanghai Mental Health Center,Shanghai Jiao Tong University School of Medicine,Shanghai 200030,China;Department of Neurology,Huashan Hospital,Fudan University,Shanghai 200040,China;Department of Oncology,West China Hospital of Sichuan University,Chengdu 610041,China;Department of On-cology,Zhejiang Cancer Hospital,Hangzhou 310022,China;Department of Respiratory Diseases,The First Affiliated Hospital,Col-lege of Medicine,Zhejiang University,Hangzhou 310003,China;Department of Oncology,Beijing Chest Hospital,Capital Medical University,Beijing 101149,China;Department of Oncology,Sichuan Cancer Hospital,Chengdu 610041,China;不详)

机构地区：[1]广东省肺癌研究所,广东省人民医院,广东省医学科学院,广州510080 [2]上海交通大学附属胸科医院肿瘤科,上海200030 [3]复旦大学附属华山医院心内科,上海200040 [4]广东省精神卫生中心精神科,广州510120 [5]上海交通大学医学院附属精神卫生中心精神科,上海200030 [6]复旦大学附属华山医院神经内科,上海200040 [7]四川大学华西医院肿瘤科,成都610041 [8]浙江省肿瘤医院肿瘤科,杭州310022 [9]浙江大学附属第一医院呼吸科,杭州310003 [10]首都医科大学附属北京市胸科医院肿瘤科,北京101149 [11]四川省肿瘤医院肿瘤内科,成都610041 [12]不详

出　　处：《中国肺癌杂志》2022年第8期555-566,共12页Chinese Journal of Lung Cancer

摘　　要：间变性淋巴瘤激酶(anaplastic lymphoma kinase,ALK)融合基因是非小细胞肺癌(non-small cell lung cancer,NSCLC)中第二常见的肿瘤驱动基因。作为新型的第三代ALK酪氨酸激酶抑制剂(tyrosine kinase inhibitor,TKI),洛拉替尼对多种ALK激酶域突变具有广谱且高效的临床活性,并具有强大的穿透血脑屏障效力。洛拉替尼的总体耐受性良好,其独特的不良反应或不良事件包括高脂血症与中枢神经系统反应等,多为轻至中度,通常经剂量调整和/或标准医疗干预即可管理。对于ALK阳性晚期NSCLC,开始洛拉替尼治疗前应充分评估患者基线特征与既往用药状况,预先告知患者可能经历的用药相关不良反应,并定期监测以实现药物临床获益的最大化。同时,多学科专家团队对于建立全面的诊断和治疗策略是至关重要的。Anaplastic lymphoma kinase(ALK)fusions represent the second most common oncogenic driver mutation in non-small cell lung cancer(NSCLC).As the new class of 3generation of ALK tyrosine kinase inhibitor(TKI),lorlatinib has shown robust potency and brain-penetrant clinical activity against a wide spectrum of multiple resistance mutations within the ALK domain detected during crizotinib and 2generation ALK TKI treatment.Lorlatinib is generally welltolerated with unique adverse drug reaction/adverse event,including hyperlipidemia and central nervous system effects,which are mostly mild to moderate severity and manageable through dosage modifications and/or standard medical intervention.For advanced NSCLC with ALK positivity,patients should be evaluated for baseline characteristics and pre-existing medication,informed of the potential toxicities,and perio dically monitored to balance benefits and risks.Moreover,a multidisciplinary group of experts is essential to establish a comprehensive diagnostic and therapeutic strategy.

关 键 词：间变性淋巴瘤激酶 肺肿瘤 洛拉替尼 不良反应 

分 类 号：R979.1[医药卫生—药品]