摘要
德曲妥珠单抗(T-DXd)作为一种新型抗体药物偶联药物,由曲妥珠单抗、可裂解的肽基连接体和拓扑异构酶Ⅰ抑制剂三部分构成,对于经治的无法切除的HER2阳性及HER2低表达转移性乳腺癌患者具有一定治疗活性。此外,该药物对脑转移人群也显示出治疗优势。血液毒性、肝功能损伤、胃肠道反应及心肺毒性是该药物常见的不良反应;间质性肺病/肺炎是研究中特别关注的不良反应,对患者生活质量影响大,需临床有效管理。该文对T-DXd的作用机制、药效学及药代动力学、相关临床研究、对HER2低表达和中枢神经系统治疗效果及不良反应等进展进行了综述。
Trastuzumab deruxtecan(T-DXd),a novel antibody-drug coupled drug consisting of three components:Trastuzumab,a cleavable peptidyl linker,and a topoisomerase I inhibitor,has shown some therapeutic activity in patients with treated unresectable HER2-positive and HER2 low-expressing metastatic breast cancer.In addition,the drug has shown therapeutic advantages in the brain metastasis population.Hematotoxicity,hepatic impairment,gastrointestinal reactions,and cardiopulmonary toxicity are common adverse effects of this drug.Interstitial lung disease/pneumonia is an adverse effect of particular concern in the study,which has a significant impact on the quality of life of the patients and needs to be effectively managed in the clinic.In this paper,the mechanism of action,pharmacodynamics and pharmacokinetics,related clinical studies of T-DXd,the therapeutic effects of T-DXd on HER2 low-expression and central nervous system,and adverse reactions are reviewed.
作者
穆玉晶
裴晓华
周剑
李建蓉
吕涉文
张芙蓉
MU Yujing;PEI Xiaohua;ZHOU Jian;LI Jianrong;LYU Shewen;ZHANG Furong(Department of Breast Surgery,the Third Affiliated Hospital of Beijing University of Chinese Medicine,Beijing 100007,China;Department of Thyroid and Breast Surgery,Qingdao Hiser Hospital Affiliated to Qingdao University,Shandong Qingdao 266033,China)
出处
《现代肿瘤医学》
2025年第10期1793-1801,共9页
Journal of Modern Oncology
基金
国家自然科学基金资助项目(编号:82374463)。
关键词
乳腺癌
德曲妥珠单抗
抗体药物偶联物
breast cancer
trastuzumab deruxtecan
antibody-drug coupler
