Advances in Clinical and Experimental Medicine

Title abbreviation: Adv Clin Exp Med
JCR Impact Factor (IF) – 1.736
5-Year Impact Factor – 2.135
Index Copernicus  – 168.52
MEiN – 70 pts

ISSN 1899–5276 (print)
ISSN 2451-2680 (online)
Periodicity – monthly

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Advances in Clinical and Experimental Medicine

2006, vol. 15, nr 4, July-August, p. 723–731

Publication type: review article

Language: Polish

Działania niepożądane molekularnego leczenia celowanego

Molecularly Targeted Therapy Side Effects

Aleksandra Łacko1,, Rafał Matkowski1,, Iwona Gisterek1,, Jacek Dryl1,

1 Katedra Onkologii AM we Wrocławiu

Streszczenie

Leki o molekularnym mechanizmie działania stały się częścią codziennej praktyki onkologicznej. Ponieważ większość preparatów stosuje się w skojarzeniu z chemioterapią, chorzy są narażeni również na niepożądane objawy indukowane cytostatykami. Utrudnia to ocenę związku powikłań z działaniem preparatów stosowanych w leczeniu celowanym. Celem pracy była charakterystyka działań niepożądanych molekularnego leczenia celowanego na podstawie przeglądu piśmiennictwa uzyskanego po przeszukaniu bazy PubMed National Library of Medicine. Leczenie tymi preparatami jest dość dobrze tolerowane. Swoiste dla nich toksyczności są uważane za mniej nasilone i lepiej tolerowane niż indukowane przez standardową chemioterapię. Większość powikłań jest odwracalna i poddaje się leczeniu objawowemu. Poważne toksyczności są rzadkie. Odpowiedni dobór chorych i monitorowanie leczenia znacząco zmniejsza ryzyko wystąpienia niebezpiecznych dla życia powikłań. Nadal bardzo niewiele wiemy o odległych powikłaniach leczenia molekularnego. Jest to wynikiem braku danych z długotrwałej obserwacji. Dalsze badania kliniczne oraz doświadczenia porejestracyjne dotyczące stosowania leków celowanych pomogą określić grupę chorych, u których ryzyko wystąpienia objawów ubocznych jest duże oraz ustalić optymalne leczenie powikłań.

Abstract

Molecularly targeted therapy became a standard in cancer treatment. Most of these drugs are used together with chemotherapy so patients are simultaneously subjected to side effects of both treatments. The authors evaluated safety and toxicity of molecularly targeted therapy basing on systematic review of the published pivotal studies reporting toxic effects of molecularly targeted therapy. Search of available literature was performed in PubMed National Library of Medicine database. Molecularly targeted therapy is generally well tolerated. Specific side effects associated with the treatment are found as mild and better tolerated when compared with toxic effects induced by conventional chemotherapy. Common side effects are reversible and manageable with symptomatic treatment. Serious side effects are rare. Patients selection and proper monitoring significantly decreases the risk of life threatening adverse events. Data concerning late side effects are still unavailable because of short follow up of molecularly targeted therapy. Further studies and postmarketing experience may be helpful in identifying subgroup of patients with high risk of toxicity and in defining optimal treatment.

Słowa kluczowe

molekularne leczenie celowane, leki przeciwnowotworowe, objawy niepożądane

Key words

molecularly targeted therapy, antineoplatic agents, toxicity

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