基于Lexicomp数据库的新型抗肿瘤药物与抑酸药的相互作用

Drug-drug interaction of novel antitumor drugs with acid-suppressing drugs based on Lexicomp database

目的分析新型抗肿瘤药物与抑酸药的相互作用,为临床合理用药提供参考。方法通过Lexicomp数据库,对国家卫生健康委员会发布的《新型抗肿瘤药物临床应用指导原则(2022版)》中收录的新型抗肿瘤药物与抑酸药的相互作用进行逐一查询并分析。结果根据Lexicomp数据库,厄洛替尼、达可替尼、达沙替尼、培唑帕尼和奈拉替尼与质子泵抑制剂/钾竞争性酸阻断剂(PPIs/PCABs)存在X级相互作用,应避免联用;吉非替尼、尼洛替尼和哌柏西利与PPIs/PCABs存在D级相互作用,建议调整治疗;索拉非尼,免疫检查点抑制剂纳武利尤单抗、帕博利珠单抗、度伐利尤单抗、阿替利珠单抗、伊匹木单抗与PPIs/PCABs存在C级相互作用,无需调整剂量;拉帕替尼、达拉非尼、塞瑞替尼、恩曲替尼、佩米替尼、索立德吉与PPIs/PCABs存在B级相互作用,不需要采取措施。达沙替尼、培唑帕尼与组胺H_(2)受体拮抗剂(H_(2)RAs)存在X级相互作用,应避免联用;吉非替尼、厄洛替尼、达可替尼、尼洛替尼、奈拉替尼与H_(2)RAs存在D级相互作用,建议调整治疗;拉帕替尼和塞瑞替尼与H_(2)RAs存在B级相互作用,不需要采取措施。结论新型抗肿瘤药物的治疗过程中应减少不必要的抑酸药的使用,以避免可能的药物相互作用。

AIM To analyze the interaction between novel antitumor drugs and acid-suppressing drugs,and provide a reference for clinical rational use.METHODS Using the Lexicomp database,the interactions between novel antitumor drugs listed in the Guidelines for Clinical Use of Novel Antitumor Drugs(2022 Edition)issued by the National Health Commission of the People’s Republic of China and acid-suppressing drugs were searched and analyzed.RESULTS According to the Lexicomp database,erlotinib,dacomitinib,dasatinib,pazopanib,and neratinib had grade X interactions with proton pump inhibitors or potassium-competitive acid blockers(PPIs/PCABs)and should be avoided in combination;gefitinib,nilotinib,and palbociclib had grade D interactions with PPIs/PCABs and therapy modification was recommended;sorafenib,the immune checkpoint inhibitors nivolumab,pembrolizumab,durvalumab,atezolizumab,and ipilimumab had grade C interactions with PPIs/PCABs and did not require dose adjustment;lapatinib,dabrafenib,ceritinib,entrectinib,pemigatinib,and sonidegib have grade B interactions with PPIs/PCABs and did not require action.Dasatinib and pazopanib had grade X interactions with histamine 2-receptor antagonists(H_(2)RAs)and should be avoided in combination;gefitinib,erlotinib,dacomitinib,nilotinib,and neratinib had grade D interactions with H_(2)RAs,and therapy modification was recommended;lapatinib and ceritinib had grade B interactions with H_(2)RAs and no action was required.CONCLUSION The use of unnecessary acid-suppressing drugs should be reduced during the treatment of novel antitumor drugs to avoid possible drug-drug interactions.