抗体-药物偶联物相关周围神经病3例  

Antibody-drug conjugates associated peripheral neuropathy:report of 3 cases

作　　者：熊德顺 刘森[3] 陈华 蒲迎[2] 郭玉坤 李恒 Xiong Deshun;Liu Sen;Chen Hua;Pu Ying;Guo Yukun;Li Heng(Cheeloo College of Medicine,Shandong University,Jinan 250012,China;Department of Neurology,Jinan Central Hospital,Jinan 250013,China;Department of Oncology,Jinan Central Hospital,Jinan 250013,China)

机构地区：[1]山东大学齐鲁医学院,济南250012 [2]济南市中心医院神经内科,济南250013 [3]济南市中心医院肿瘤科,济南250013

出　　处：《中华神经科杂志》2025年第2期179-183,共5页Chinese Journal of Neurology

摘　　要：抗体-药物偶联物(ADC)是目前发展最为快速的抗肿瘤药物种类之一,以单甲基奥瑞他汀E(MMAE)为代表的微管蛋白结合剂是ADC中应用最广的有效载荷,也是引起周围神经病变(PN)的最主要成分。本文报道了3例发生严重PN并发症的基于MMAE的ADC使用患者,通过描述3例患者的临床特点和诊治经过,结合相关文献对该病的临床表现和治疗转归进行总结:ADC有效载荷MMAE相关周围神经病的发生与ADC的使用周期和时间有关;不同于传统化疗诱导的PN,基于MMAE的ADC相关PN表现为长度依赖性的运动和感觉神经受累,运动神经受累和深感觉障碍更为严重;3例患者有2例接受了血浆置换或足量足疗程的免疫球蛋白冲击治疗,均在短期内获得了良好的转归,提示针对ADC药物进行有效的清除治疗,可以较为快速地缓解ADC相关PN的症状。Antibody-drug conjugates(ADC)are one of the most popular types of anti-tumor drugs nowadays.Monomethyl auristatin E(MMAE),as a tubulin binder,is the most common applied payload in ADC and is also the main component that causes peripheral neuropathy(PN).By describing the clinical characteristics of 3 cases with MMAE ADC associated severe PN complications and analyzing reported references,this article summarizes that the occurrence of MMAE ADC associated PN is correlated with therapeutic cycles and duration of ADC,MMAE ADC associated PN is different from traditional chemotherapy-induced PN in the clinical presentation.Patients with MMAE ADC associated PN may present with a length-dependent involvement of peripheral motor and sensory nerves,and generally their weakness and deep sensory deficiency symptoms are more serious compared with traditional chemotherapy-induced PN.Two of the 3 patients achieved a relatively rapid recovery after treated with plasma exchange or immunoglobulin intravenous infusions.

关 键 词：抗肿瘤药 微管蛋白 周围神经系统疾病 抗体-药物偶联物 

分 类 号：R745[医药卫生—神经病学与精神病学]