[癌症化疗性贫血的现状与展望]。

D L Zhao, J Ma
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引用次数: 0

摘要

化疗性贫血(Chemotherapy-induced anemia, CIA)是癌症患者最常见的并发症之一。如果CIA治疗效果不佳,将影响化疗方案的正常实施,降低患者的生活质量,缩短临床生存期。目前,CIA在治愈率和疗效方面存在严重不足。在临床实践中,由于贫血不能快速有效地治疗,常常被迫减少化疗剂量或延迟化疗。这些问题主要与该病病因复杂、临床干预时间较晚、现有治疗方案存在一定局限性等因素有关。因此,疾病管理需要进一步强化早诊断、早治疗的观念,避免因贫血的严重程度而增加临床负担。同时,随着对贫血机制的深入了解,基于缺氧诱导因子(hypoxia-inducible factor, HIF)综合调控机制的新药研发已开始进入临床实践。Roxostat治疗非髓质恶性肿瘤患者化疗性贫血的Ⅲ期临床研究于2023年在欧洲医学肿瘤学会(ESMO)会议上公布。该低氧诱导因子脯氨酰羟化酶抑制剂(HIF-PHI)药物为口服制剂,在本研究中已显示出良好的疗效和安全性,且与重组人促红细胞生成素-α (rHuEPO-α)相比具有优越的依从性。本文从对CIA机制的重新认识出发,分析了CIA目前的诊疗困境,结合《中国临床肿瘤学会(CSCO)肿瘤相关性贫血临床实践指南(2024)》提出了建议,并对未来治疗新药HIF-PHI进行了介绍和展望。
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[Status and prospect of cancer chemotherapy-induced anemia].

Chemotherapy-induced anemia (CIA) is one of the most common complications in cancer patients. If CIA treatment is not effective, it will affect the normal implementation of chemotherapy regimens, and reduce the quality of life of patients and shorten clinical survival. At present, CIA has serious shortcomings in treatment rate and unsatisfactory therapeutic effect. It is often forced to reduce the dose of chemotherapy or delay chemotherapy due to anemia that cannot be rapidly and effectively treated in clinical practice. These problems are mainly related to factors such as complex etiology of the disease, late timing of clinical intervention, and certain limitations in existing treatment options. Therefore, disease management needs to further strengthen the concept of early diagnosis and early treatment to avoid the increased clinical burden due to the severity of anemia. Meanwhile, with the in-depth understanding of the mechanism of anemia, new drug research and development based on the comprehensive regulatory mechanism of hypoxia-inducible factor (HIF) has begun in clinical practice. A phase Ⅲ clinical study of Roxostat in the treatment of chemotherapy-induced anemia in patients with non-medullary malignancies was presented at the European Society of Medical Oncology (ESMO) conference in 2023. This hypoxia-inducible factor prolyl hydroxylase inhibitor (HIF-PHI) drug is an oral preparation, which has shown good efficacy and safety in the study, and has superior compliance compared with recombinant human erythropoietin-α (rHuEPO-α). Starting from the re-understanding of the mechanism of CIA, this review analyzes the current diagnosis and treatment dilemmas of CIA, puts forward suggestions in combination with the "Guildlines of Chinese Society of Clinical Oncology (CSCO) clinical practice in tumor-related anemia (2024)", and introduces and looks forward to HIF-PHI, a new therapeutic drug in the future.

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来源期刊
Zhonghua yi xue za zhi
Zhonghua yi xue za zhi Medicine-Medicine (all)
CiteScore
0.80
自引率
0.00%
发文量
400
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