Adverse drug reactions associated with tyrosine kinase inhibitors in cancer patients: A retrospective cross-sectional study
Các tác giả
DOI: https://doi.org/10.59294/HIUJS20250112Từ khóa:
oncology, targeted therapy, tyrosine kinase inhibitors, adverse drug reactionsTóm tắt
Background: Tyrosine kinase inhibitors (TKIs) demonstrate superior efficacy over conventional chemotherapy but are associated with various adverse drug reactions (ADRs) that can compromise therapeutic efficacy and patient adherence. Objectives: This study analyzed the ADRs associated with tyrosine kinase inhibitors (TKIs) prescribed for cancer patients undergoing treatment at the Oncology Department of Nhan Dan Gia Dinh Hospital. Methods: A retrospective cross-sectional study was conducted using outpatient records and TKI prescriptions collected from treatment encounters from June 2024 to June 2025. Results: Among the 449 TKI-containing prescriptions reviewed, 416 (92.7%) were associated with at least one ADR, while 33 prescriptions (7.3%) reported no ADRs. The most prevalent toxicities involved gastrointestinal (59.2%), skin and subcutaneous tissue disorders (58.6%), and hepatobiliary disorders (30.7%). Serious adverse events included interstitial lung disease (8.9%) and cardiac disorders (2.4%). Other observed ADRs were eye and general disorders (e.g., fatigue). Regarding concurrent toxicity (N = 416), 69.5% of cases involved 1-3 ADRs, while 23.2% experienced more than 3 ADRs. This high frequency of ADRs per TKI prescription reflects the complexity of the toxicity profile and the significant risk of patients facing concurrent adverse effects during targeted therapy. Conclusion: The use of TKIs in cancer patients is associated with a high prevalence of ADRs, primarily manifesting as gastrointestinal, skin, and subcutaneous tissue disorders, hepatobiliary disorders. These findings underscore the importance of careful monitoring and management of ADRs to optimize treatment efficacy. Furthermore, the frequent occurrence of concurrent ADRs necessitates a comprehensive pharmacovigilance approach. Early detection and proactive management of these toxicities are crucial to maintain treatment adherence and preserve the quality of life for cancer patients.
Abstract
Background: Tyrosine kinase inhibitors (TKIs) demonstrate superior efficacy over conventional chemotherapy but are associated with various adverse drug reactions (ADRs) that can compromise therapeutic efficacy and patient adherence. Objectives: This study analyzed the ADRs associated with tyrosine kinase inhibitors (TKIs) prescribed for cancer patients undergoing treatment at the Oncology Department of Nhan Dan Gia Dinh Hospital. Methods: A retrospective cross-sectional study was conducted using outpatient records and TKI prescriptions collected from treatment encounters from June 2024 to June 2025. Results: Among the 449 TKI-containing prescriptions reviewed, 416 (92.7%) were associated with at least one ADR, while 33 prescriptions (7.3%) reported no ADRs. The most prevalent toxicities involved gastrointestinal (59.2%), skin and subcutaneous tissue disorders (58.6%), and hepatobiliary disorders (30.7%). Serious adverse events included interstitial lung disease (8.9%) and cardiac disorders (2.4%). Other observed ADRs were eye and general disorders (e.g., fatigue). Regarding concurrent toxicity (N = 416), 69.5% of cases involved 1-3 ADRs, while 23.2% experienced more than 3 ADRs. This high frequency of ADRs per TKI prescription reflects the complexity of the toxicity profile and the significant risk of patients facing concurrent adverse effects during targeted therapy. Conclusion: The use of TKIs in cancer patients is associated with a high prevalence of ADRs, primarily manifesting as gastrointestinal, skin, and subcutaneous tissue disorders, hepatobiliary disorders. These findings underscore the importance of careful monitoring and management of ADRs to optimize treatment efficacy. Furthermore, the frequent occurrence of concurrent ADRs necessitates a comprehensive pharmacovigilance approach. Early detection and proactive management of these toxicities are crucial to maintain treatment adherence and preserve the quality of life for cancer patients.
Tài liệu tham khảo
[1] Y. Fu, X. Wei, L. Lin, W. Xu, and J. Liang, "Adverse reactions of sorafenib, sunitinib, and imatinib in treating digestive system tumors," (in eng), Thoracic cancer, vol. 9, no. 5, pp. 542-547, May 2018, doi: 10.1111/1759-7714.12608.
[2] A. Płużański and A. J. O. i. C. P. Piórek, "Side effects of tyrosine kinase inhibitors- management guidelines," (in eng), vol. 12, no. 4, pp. 113-118, 2016.
[3] M. Pretel-Irazabal, A. Tuneu-Valls, and N. J. A. D.-S. Ormaechea-Pérez, "Adverse skin effects of imatinib, a tyrosine kinase inhibitor," (in eng), vol. 105, no. 7, pp. 655-662, 2014.
[4] S. Shyam Sunder, U. C. Sharma, and S. Pokharel, "Adverse effects of tyrosine kinase inhibitors in cancer therapy: pathophysiology, mechanisms and clinical management," Signal Transduction and Targeted Therapy, vol. 8, no. 1, p. 262, 2023/07/07 2023, doi: 10.1038/s41392-023-01469-6.
[5] R. J. Cersosimo, "Gefitinib: an adverse effects profile," (in eng), Expert Opin Drug Saf, vol. 5, no. 3, pp. 469-79, May 2006, doi: 10.1517/14740338.5.3.469.
[6] L. Rimassa and A. Santoro, "Sorafenib therapy in advanced hepatocellular carcinoma: the SHARP trial," (in eng), Expert review of anticancer therapy, vol. 9, no. 6, pp. 739-45, Jun 2009, doi: 10.1586/era.09.41.
[7] K. Tamura and M. Fukuoka, "Gefitinib in non-small cell lung cancer," (in eng), Expert Opinion on Pharmacotherapy, vol. 6, no. 6, pp. 985-993, 2005/06/01 2005, doi: 10.1517/14656566.6.6.985.
[8] R. R. Shah, J. Morganroth, and D. R. Shah, "Hepatotoxicity of Tyrosine Kinase Inhibitors: Clinical and Regulatory Perspectives," (in eng), Drug Safety, vol. 36, no. 7, pp. 491-503, 2013/07/01 2013, doi: 10.1007/s40264-013-0048-4.
[9] Y. Yang, S. Tan, Y. Pu, and J. Zhang, "Safety Profile and Hepatotoxicity of Anaplastic Lymphoma Kinase Tyrosine Kinase Inhibitors: A Disproportionality Analysis Based on FDA Adverse Event Reporting System Database," (in eng), Toxics, vol. 13, no. 3, p. 210, 2025.
[10] T. Ohmori et al., "Molecular and Clinical Features of EGFR-TKI-Associated Lung Injury," (in eng), Int J Mol Sci, vol. 22, no. 2, Jan 14 2021, doi: 10.3390/ijms22020792.
[11] X. Miao, Y. Liu, X. Li, and R. Zhao, "Risk of interstitial lung disease in non-small cell lung cancer treated with EGFR-TKI: a real-world pharmacovigilance study," (in eng), Frontiers in Pharmacology, vol. 16, p. 1652750, 2025.
[12] Z. Tang et al., "A pharmacovigilance study of thromboembolism events associated with vascular endothelial growth factor receptor tyrosine kinase inhibitors based on FAERS database," (in eng), Scientific Reports, vol. 15, no. 1, p. 25120, 2025/07/11 2025, doi: 10.1038/s41598-025-11067-x.
[13] D. J. Lenihan and P. R. Kowey, "Overview and management of cardiac adverse events associated with tyrosine kinase inhibitors," (in eng), The oncologist, vol. 18, no. 8, pp. 900-908, 2013.
[14] J.-Y. Lee, J.-W. Choi, and H. Kim, "Determination of body surface area and formulas to estimate body surface area using the alginate method," (in eng), Journal of Physiological Anthropology, vol. 27, no. 2, pp. 71-82, 2008.
[15] L. Yang et al., "Sex Differences in the Expression of Drug-Metabolizing and Transporter Genes in Human Liver," (in eng), J Drug Metab Toxicol, vol. 3, no. 3, p. 1000119, 2012, doi: 10.4172/2157- 7609.1000119.
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