培美曲塞是常用的抗肿瘤药物,常用于非鳞状非小细胞肺癌、恶性胸膜间皮瘤的治疗。本文总结了培美曲塞的作用机制、不良反应及其相关的预防用药和用药调整。
一、作用机制
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ANC≥1500 cells/mm3
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血小板计数≥100000 cells/mm3
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CrCl≥45 ml/min
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总胆红素≤1.5倍正常值上限
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ALP、AST和ALT≤3倍正常值上限,或5倍正常值上限(肿瘤影响肝脏时可考虑)
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ANC:绝对嗜中性粒细胞计数绝对值
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CrCl:肌酐清除率
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ALP:碱性磷酸酶
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AST:天冬氨酸氨基转移酶
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ALT:丙氨酸氨基转移酶
参考文献:
1. Lexicomp Online, Lexi-Drugs Online. Waltham,MA: UpToDate, Inc.; April 1, 2022. https://online.lexi.com. Accessed April 18, 2022.
2. 药物说明书, 培美曲塞二钠, AccessedApril 18, 2022.
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5. Singh N, Baldi M, Kaur J, et al. Timing offolic acid/vitamin B12 supplementation and hematologic toxicity duringfirst-line treatment of patients with nonsquamous non-small cell lung cancerusing pemetrexed-based chemotherapy: The PEMVITASTART randomized trial. Cancer.2019;125(13):2203-2212. doi:10.1002/cncr.32028
6. Kim YS, Sun JM, Ahn JS, Ahn MJ, Park K. Theoptimal duration of vitamin supplementation prior to the first dose ofpemetrexed in patients with non-small-cell lung cancer. Lung Cancer.2013;81(2):231-235. doi:10.1016/j.lungcan.2013.04.011
7. Takagi Y, Hosomi Y, Sunami K, et al. Aprospective study of shortened vitamin supplementation prior tocisplatin-pemetrexed therapy for non-small cell lung cancer. Oncologist.2014;19(11):1194-1199. doi:10.1634/theoncologist.2014-0221
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作者:与非
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