HEMATOLOŠKE TOKSIČNOSTI INHIBITORA CIKLIN ZAVISNIH KINAZA 4 I 6 U LEČENJU METASTATSKOG KARCINOMA DOJKE, ISKUSTVA JEDNOG CENTRA
Sažetak
Uvod: Hematološke toksičnosti predstavljaju najčešće neželjeno dejstvo primene CDK4/6 inhibitora (CDK4/6i). Zbog novine ovih lekova, postoji potreba za dodatnim podacima koji bi identifikovali potencijalne predisponirajuće faktore za razvoj hematoloških toksičnosti.
Cilj rada: Ova studija ima za cilj da ispita potencijalne predisponirajuće faktore za razvoj hematološke toksičnosti tokom primene CDK 4/6i u cilju lečenja metastatskog karcinoma dojke.
Materijal: U ovoj retrospektivnoj deskriptivnoj studiji ispitana je primena CDK4/6i kod pacijentkinja sa metastatskim karcinomom dojke, lečenih na Odeljenju dojke IORSa u periodu od 1.1.2021 do 1.6.2024.
Rezultati: U studiju je uključeno 128 pacijentkinja; 43% je bilo na terapiji palbociclibom, a 57% ribociclibom. Medijana starosti bila je 60 godina. Medijana praćenja iznosila je 12 meseci (opseg 2-23). Neutropenija je uočena kod 82,1% pacijentkinja, a gradus 3/4 kod 43%. Redukcija doze zbog ponavljanih neutropenija gradusa 3/4 bila je potrebna kod 21,1% ispitanica. Anemije i trombocitopenije gradusa 3/4 primećene su kod 0.8% i 1,6% pacijenata. Obustava terapije zbog hematoloških toksičnosti bila je neophodna kod 1,5% pacijentkinja. Nije bilo statistički značajne razlike između dva leka u pogledu incidence hematološke toksičnosti (p=0,443). Prethodna primena hemioterapije u metastatskoj fazi bolesti nije bila značajno povezana sa učestalošću hematološke toksičnosti (p=0,565). Palijativna radioterapija koštanih lezija pokazala je statistički značajnu povezanost sa potrebom za redukcijom doze CDK4/6i (p=0,001, r=0,283). Medijana preživljavanja bez progresije bolesti (PFS) nije dostignuta, ali nije postojao trend koji bi ukazivao na to da redukcija doze CDK4/6i utiče na PFS (p=0,719).
Zaključak: Palijativna radioterapija koštanih lezija je povezana je sa češćom redukcijom doze CDK4/6i, ali redukcija doze ovih lekova nije uticala na dužinu preživljavanja.
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