胃癌抗体偶联药物不良事件的发生机制及管理策略  

Adverse events of antibody-drug conjugates in gastric cancer:formation mechanisms and management strategies

作　　者：徐晓晶 余一祎[1,2] 刘青 于珊[1,2] 冯艺 刘天舒[1,3] XU Xiaojing;YU Yiyi;LIU Qing;YU Shan;FENG Yi;LIU Tianshu(Department of Medical Oncology,Cancer Center,Zhongshan Hospital,Fudan University,Shanghai 200032,China)

机构地区：[1]复旦大学附属中山医院肿瘤内科,上海200032 [2]复旦大学附属中山医院肿瘤防治中心,200032 [3]复旦大学附属中山医院循证医学中心,200032

出　　处：《临床肿瘤学杂志》2023年第8期751-759,共9页Chinese Clinical Oncology

摘　　要：胃癌是一种发病率高且预后较差的消化道恶性肿瘤。人表皮生长因子受体2(HER2)与胃癌的发生和发展密切相关,也作为重要的治疗靶点而被各大临床指南推荐。近年来,新一代抗体偶联药物(ADC)通过特定的连接子将靶向HER2的特异性抗体和高杀伤性的细胞毒药物偶联起来,通过靶向化疗的方式将细胞毒性药物释放至肿瘤细胞并将其杀死,该独特作用机制已在多种实体肿瘤中展示出优异的临床疗效。其中,德曲妥珠单抗和维迪西妥单抗已获得批准,并应用于HER2阳性的晚期胃癌患者的临床治疗。为帮助临床医生更好的认识和应用ADC药物,本文对当前胃癌领域ADC药物的常见不良反应谱进行梳理,并探讨其发生机制与临床管理策略,旨在惠及更多胃癌患者。Gastric cancer is a malignant tumour of the digestive tract with a high incidence and poor prognosis.Human epidermal growth factor receptor 2(HER2)is associated with the development and progression of gastric cancer and is also recommended as an important therapeutic target for cancer by various guidelines.Recently,a new generation of antibody-drug conjugates(ADCs),which consists of a HER2-specific antibody linked to a highly lethal cytotoxic drug,have shown excellent clinical efficacy in a variety of solid tumours through targeting HER2-expressing tumour cells for delivery of cytotoxic drugs to kill tumour cells.Among the new generation anti-HER2 ADCs,trastuzumab deruxtecan and disitamab vedotin have been approved for the treatment of patients with HER2-positive advanced gastric cancer.In order to help clinicians better understand,evaluate and apply ADCs in clinical practice,we summarized the common adverse events of ADCs that occurred during the treatment of patients with gastric cancer,as well as discuss their mechanisms of occurrence and management strategies.

关 键 词：晚期胃癌 抗体偶联药物 不良事件 发生机制 管理策略 

分 类 号：R735.2[医药卫生—肿瘤]