Management of Peripheral Edema in Patients with MET Exon 14-Mutated Non-small Cell Lung Cancer Treated with Small Molecule MET Inhibitors.
Management of Peripheral Edema in Patients with MET Exon 14-Mutated Non-small Cell Lung Cancer Treated with Small Molecule MET Inhibitors.
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DOI：
10.1007/s11523-022-00912-y
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发表时间：
2022-09
影响因子：
5.4
通讯作者：
中科院分区：
文献类型：
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小分子间质-上皮转化（MET）抑制剂，如克唑替尼、capmatinib和tepotinib，是转移性非小细胞肺癌（NSCLC）成人患者的治疗选择，这些患者的肿瘤突变导致MET外显子14跳读。在临床试验中，这些MET抑制剂与外周水肿的高发生率相关，尽管其严重程度通常为轻度至中度。关于MET受体诱导外周水肿的机制信息有限。肝细胞生长因子（HGF）/MET信号转导的扰动可能会破坏血管内皮的通透性平衡，从而促进水肿的发展。另一个潜在机制是通过对肾功能的影响，尽管这不太可能是主要机制。由于水肿在癌症患者中很常见，可能不一定是由癌症治疗或其他与外周水肿症状相似的疾病引起的，因此需要进行全面评估以确定根本原因。在开始MET抑制剂治疗之前，应告知患者发生外周水肿的可能性。开始治疗前应测量患者肢体体积，以帮助评估是否出现症状。由于MET支架诱导水肿的确切机制尚不清楚，因此管理是经验性的，常用方法包括加压袜、特定运动、按摩、肢体抬高和/或利尿剂治疗。虽然通常不需要，但停止MET抑制剂治疗通常可缓解外周水肿。早期诊断和管理，以及患者信息和教育，对于减少与水肿相关的临床负担和加强capmatinib治疗依从性至关重要。
Small molecule mesenchymal-epithelial transition (MET) inhibitors, such as crizotinib, capmatinib, and tepotinib, are treatment options for metastatic non-small cell lung cancer (NSCLC) in adult patients whose tumors have a mutation that leads to MET exon 14 skipping. In clinical trials, these MET inhibitors were associated with a high incidence of peripheral edema, although this was generally mild-to-moderate in severity. There is limited information about the mechanism involved in MET inhibitor-induced peripheral edema. Perturbation of hepatocyte growth factor (HGF)/MET signaling may disrupt the permeability balance in the vascular endothelium and thus promote edema development. Another potential mechanism is through effects on renal function, although this is unlikely to be the primary mechanism. Because edema is common in cancer patients and may not necessarily be caused by the cancer treatment, or other conditions that have similar symptoms to peripheral edema, a thorough assessment is required to ascertain the underlying cause. Before starting MET-inhibitor therapy, patients should be educated about the possibility of developing peripheral edema. Patient limb volume should be measured before initiating treatment, to aid assessment if symptoms develop. Since the exact mechanism of MET inhibitor-induced edema is unknown, management is empiric, with common approaches including compression stockings, specific exercises, massage, limb elevation, and/or diuretic treatment. Although not usually required, discontinuation of MET inhibitor treatment generally resolves peripheral edema. Early diagnosis and management, as well as patient information and education, are vital to decrease the clinical burden associated with edema, and to reinforce capmatinib treatment adherence.
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影响因子：
82.9
作者：
Drilon A;Clark JW;Weiss J;Ou SI;Camidge DR;Solomon BJ;Otterson GA;Villaruz LC;Riely GJ;Heist RS;Awad MM;Shapiro GI;Satouchi M;Hida T;Hayashi H;Murphy DA;Wang SC;Li S;Usari T;Wilner KD;Paik PK
通讯作者：
Paik PK
影响因子：
11.5
作者：
Markham, Anthony
通讯作者：
Markham, Anthony
影响因子：
11.5
作者：
Falchook, Gerald S.;Kurzrock, Razelle;Hong, David S.
通讯作者：
Hong, David S.
影响因子：
8.8
作者：
Kamba, T;McDonald, D M
通讯作者：
McDonald, D M
DOI：
10.1016/s2213-2600(21)00084-9
发表时间：
2021-10-01
期刊：
The Lancet. Respiratory medicine
影响因子：
--
作者：
Lu, Shun;Fang, Jian;Su, Weiguo
通讯作者：
Su, Weiguo