细胞周期蛋白依赖性激酶4/6抑制剂致血栓的研究进展  

Research progress in cyclin-dependent kinase 4/6 inhibitors-related thrombosis

作　　者：王旭东 汪龙[3] 黄佩文 葛磊 WANG Xudong;WANG Long;HUANG Peiwen;GE Lei(Department of Pharmacy,the Third Affiliated Hospital of Anhui Medical University,Hefei First People’s Hospital,Anhui Hefei 230000,China;Department of Oncology,the Third Affiliated Hospital of Anhui Medical University,Hefei First People’s Hospital,Anhui Hefei 230000,China;Department of Pharmacy,the Third People’s Hospital of Bengbu,Anhui Bengbu 233099,China)

机构地区：[1]安徽医科大学第三附属医院,合肥市第一人民医院药学部,安徽合肥230000 [2]安徽医科大学第三附属医院,合肥市第一人民医院肿瘤内科,安徽合肥230000 [3]蚌埠市第三人民医院药学部,安徽蚌埠233099

出　　处：《中国医院药学杂志》2025年第7期834-839,844,共7页Chinese Journal of Hospital Pharmacy

摘　　要：细胞周期蛋白依赖性激酶(cyclin-dependent kinase,CDK)4/6抑制剂是靶向作用于CDK,通过阻止细胞从G1期进入S期来达到抑制肿瘤细胞持续增殖的新型抗肿瘤药物。常联合内分泌疗法用于治疗激素受体阳性(hormone receptor-positive,HR+)、人表皮生长因子受体2阴性(human epidermal growth factor receptor 2-negative,HER2-)的不可切除或转移性乳腺癌患者。血栓栓塞是CDK4/6抑制剂的严重不良反应之一,其机制可能与CDK参与内皮细胞介导的血小板活化调节或CDK相关的肿瘤细胞特异性突变相关。临床表现主要为肺栓塞、深静脉血栓、内脏静脉血栓、脑静脉血栓、短暂性脑缺血、心肌梗死等,严重时可危及患者生命。其发生的危险因素包括年龄、血栓病史、体重指数、血常规数值、高血压、高脂血症、糖尿病和联合用药。CDK4/6抑制剂治疗时应评估患者的血栓风险,以便及时发现和干预可能发生的血栓栓塞事件。Cyclin-dependent kinase(CDK)4/6 inhibitors are new anti-tumor drugs that target CDK and inhibit the continuous proliferation of tumor cells by preventing cell cycle progression from the G1 phase to S phase.They are often combined with endocrine therapy for the treatment of unresectable or metastatic,hormone receptor-positive(HR+),human epidermal growth factor receptor 2-negative(HER2-)breast cancer.Thromboembolism is one of the serious adverse events of CDK4/6 inhibitors,due to the involvement of CKD in endothelium-mediated regulation of platelet activation or CDK-related tumor-specific mutations.The main clinical manifestations are pulmonary embolism,deep vein thrombosis,visceral vein thrombosis,cerebral venous thrombosis,transient ischemic attack,and myocardial infarction,which can be even life-threatening in severe cases.Age,history of thrombosis,body mass index,blood routine values,hypertension,hyperlipidemia,diabetes mellitus and drug combination are established risk factors for thrombosis caused by CKD4/6 inhibitors.The risk of thrombosis should be assessed during CDK4/6 inhibitor therapy,in order to detect and intervene possible thromboembolic events in time.

关 键 词：细胞周期蛋白依赖性激酶4/6抑制剂 乳腺癌 不良反应 血栓栓塞 

分 类 号：R979.1[医药卫生—药品] R969.3[医药卫生—药学]