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АЛГОРИТМЫ ВЕДЕНИЯ ПАЦИЕНТОВ С НЕЖЕЛАТЕЛЬНЫМИ ЯВЛЕНИЯМИ НА ФОНЕ ТЕРАПИИ ИНГИБИТОРАМИ ТИРОЗИНКИНАЗЫ EGFR

https://doi.org/10.21518/2079-701X-2017-6-38-50

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Аннотация

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.

Об авторе

Д. Д. САКАЕВА
Республиканский клинический онкологический диспансер Министерства здравоохранения Республики Башкортостан
Россия
д.м.н., профессор


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