medsovetМедицинский СоветMeditsinskiy sovet = Medical Council2079-701X2658-5790REMEDIUM GROUP Ltd.10.21518/2079-701X-2017-6-38-50medsovet-1885Research ArticleТАРГЕТНАЯ ТЕРАПИЯ ОПУХОЛЕЙTarget therapy of tumorsАЛГОРИТМЫ ВЕДЕНИЯ ПАЦИЕНТОВ С НЕЖЕЛАТЕЛЬНЫМИ ЯВЛЕНИЯМИ НА ФОНЕ ТЕРАПИИ ИНГИБИТОРАМИ ТИРОЗИНКИНАЗЫ EGFRALGORITHMS FOR MANAGEMENT OF PATIENTS WITH ADVERSE EVENTS ON THERAPY WITH TYROSINE KINASE INHIBITORS EGFRСАКАЕВАД. Д.SAKAEVAD. D.

д.м.н., профессор

MD, Prof.

Республиканский клинический онкологический диспансер Министерства здравоохранения Республики БашкортостанРоссияRepublican Oncologic Dispensary of the Ministry of Health of the Republic of BashkortostanRussian Federation201717062017063850Copyright © САКАЕВА Д.Д., 20172017САКАЕВА Д.Д.SAKAEVA D.D.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.med-sovet.pro/jour/article/view/1885

Ингибиторы тирозинкиназы (ИТК) рецептора эпидермального фактора роста (EGFR), такие как гефитиниб, эрлотиниб и афатиниб, являются стандартом терапии первой линии местнораспространенного и метастатического немелкоклеточного рака легкого (НМРЛ) с частыми мутациями гена EGFR. Эти препараты более эффективны с точки зрения частоты ответа (ЧО) и выживаемости без прогрессирования (ВБП), менее токсичны и лучше переносятся, чем стандартная двухкомпонентная химиотерапия на основе препаратов платины. Наиболее частыми нежелательными явлениями (НЯ) являются желудочно-кишечные (ЖК) (диарея и стоматит/мукозит) и дерматологические (сыпь, сухость кожи и паронихия). Они, как правило, легкой степени тяжести, однако в некоторых случаях проявления могут быть средней и более степени тяжести и оказывают отрицательное влияние на качество жизни (КЖ) пациента и могут потребовать коррекции дозы или прекращения лечения. Управление НЯ, включая профилактические меры, поддерживающую терапию, временную отмену и снижение дозы препарата, имеет важное значение. Разработаны рекомендации по профилактике и лечению дерматологической токсичности (сыпь, сухость кожи и паронихия) и токсичности со стороны желудочно-кишечного тракта (диарея, стоматит и мукозит), связанных с терапией ИТК-EGFR. Эти рекомендации подробно описывают поддерживающую терапию, временную отмену лечения и снижение дозы препарата для ИТК-EGFR.

The tyrosine kinase inhibitors (TKIs) of the epidermal receptor growth factor (EGFR) such as gefitinib, erlotinib and afatinib, are the standard first-line therapy in locally advanced and metastatic non-small cell lung cancer (NSCLC) with frequent mutations of the EGFR gene. These drugs are more effective from the point of view of frequency response (FR) and survival without progression (SWP), less toxic and better tolerated than the standard two-component chemotherapy based on platinum drugs. The most frequent adverse events (AE) are gastrointestinal (GI) (diarrhea and stomatitis/mucositis) and dermatological (rash, dry skin and paronychia). They are usually mild, but in some cases symptoms can be moderate and more severity and have a negative impact on quality of life (QOL) of the patient and can require dose adjustment or discontinuation of treatment. Management of AEs, including preventive measures, supportive therapy, temporary cancellation and a reduction in the dose of the drug is important. Recommendations for the prevention and treatment of dermatological toxicity (rash, dry skin and paronychia) and toxicity for the gastrointestinal tract (diarrhoea, stomatitis and mucositis) related to therapy TKI-EGFR are developed. These guidelines describe in detail supportive therapy, the temporary discontinuation of the treatment and reducing the dose of the drug for KTI-EGFR.

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The authors declare that there are no conflicts of interest present.