恩美曲妥珠单抗致乳腺癌患者血小板减少症的研究进展

Research progress on thrombocytopenia induced by ado-trastuzumab emtansine in breast cancer patients

恩美曲妥珠单抗(T-DM1)是曲妥珠单抗和恩坦辛的偶联物,为人表皮生长因子受体-2(HER2)阳性乳腺癌患者新辅助治疗后残留浸润性病灶的辅助治疗和晚期乳腺癌的解救治疗选择药物之一。血小板减少症是T-DM1的常见不良反应之一。该药治疗期间所有级别血小板减少症的发生率为3.6%~38.2%,≥3级血小板减少症的发生率为0.4%~14.3%。亚裔人群、铂类药物经治者和基线血小板计数≤200×109/L者发生血小板减少症的风险较高。T-DM1导致血小板减少症的机制尚不明确,治疗期间应注意监测,对发生血小板减少的患者按严重程度分级治疗。

Ado-trastuzumab emtansine(T-DM1)is a conjugate of trastuzumab and emtansine,which is one of the options for adjuvant therapy of residual invasive lesions after neoadjuvant therapy and rescue treatment of advanced breast cancer in patients with human epidermal growth factor receprot 2(HER2)mutation.Thrombocytopenia is one of the common adverse reactions of T-DM1.The incidence of all grade of thrombocytopenia was 3.6%-38.2%,and the incidence of grade 3 and above of thrombocytopenia was 0.4%-14.3% during treatment.The risk of thrombocytopenia is higher in Asian populations,patients with prior therapy of platinum,and those with a baseline platelet count of≤200×109/L.The mechanism of thrombocytopenia caused by T-DM1 is not clear.Attention should be paid to monitoring platelet count during treatment,and patients with thrombocytopenia should be treated according to the severity.