非小细胞肺癌EGFR-TKIs治疗药物相关皮疹的影响因素及发生机制概述  

Review of influencing factors and mechanisms of EGFR-TKIs-associated rash in non-small cell lung cancer

作　　者：宋姗姗 姜福胜[1] 王亮 黄博臻 刘馨心 姜敏[1] SONG Shanshan;JIANG Fusheng;WANG Liang;HUANG Bozhen;LIU Xinxin;JIANG Min(Beijing Shijitan Hospital,Capital Medical University,Beijing 100038,China)

机构地区：[1]首都医科大学附属北京世纪坛医院,北京100038

出　　处：《现代肿瘤医学》2024年第24期4663-4673,共11页Journal of Modern Oncology

基　　金：国家中医药管理局基本中医药循证能力建设项目(编号:2019XZZX-JB004);铁道部专项课题(编号:J2020Z606);北京市中医药科技发展资金项目(编号:JJ-2020-57)。

摘　　要：非小细胞肺癌(non-small cell lung cancer,NSCLC)是我国最常见的恶性肿瘤,表皮生长因子受体酪氨酸激酶抑制剂(epidermal growth factor receptor tyrosine kinase inhibitors,EGFR-TKIs)治疗驱动基因EGFR突变阳性的NSCLC效果显著,是目前EGFR突变晚期NSCLC的一线标准治疗方案。但在口服EGFR-TKIs过程中,皮疹是最常见的不良反应。皮疹引起的不适感及外貌改变是导致治疗减量或中断的重要原因之一,影响靶向治疗的依从性。皮肤毒性反应使患者因皮肤病症状而感到忧虑,沮丧和抑郁,影响其社交活动,而社交孤立可导致抑郁的发作或原发疾病的恶化,会影响患者的生活质量,进而影响原发病的治疗。因此,本文旨在通过综述EGFR-TKIs相关皮疹的影响因素及发生机制,加强对药物相关性皮疹的理解和判断,帮助临床对药物相关性皮疹的早期诊断和正确处理,指引未来基于机制的诊断与治疗,从而改善患者生活质量。Non-small cell lung cancer(NSCLC)is the most frequent malignant tumor in China.Epidermal growth factor receptor tyrosine kinase inhibitors(EGFR-TKIs)are effective in the treatment of driver gene EGFR mutation-positive NSCLC,and they are currently the first-line standard treatment option for EGFR-mutated advanced NSCLC.However,rash is the most common adverse reaction during oral administration of EGFR-TKIs.The discomfort and change in appearance caused by rash is one of the most important causes of treatment reduction or interruption,which affects the adherence to targeted therapy.Dermatotoxic reactions make patients feel apprehensive,frustrated and depressed due to dermatologic symptoms,affecting their social activities,and social isolation can lead to episodes of depression or worsening of the primary disease,which can affect the patient's quality of life,and consequently,the treatment of the primary disease.Therefore,the aim of this paper is to enhance the understanding and judgment of drug-associated rash by reviewing the influencing factors and mechanisms of EGFR-TKIs-associated rash,to help the early diagnosis and correct management of drug-associated rash in clinical practice,and to guide the future diagnosis and treatment based on the mechanism,so as to improve the quality of life of patients.

关 键 词：非小细胞肺癌 靶向治疗 EGFR-TKIS 皮疹 机制 

分 类 号：R734.2[医药卫生—肿瘤]