Incidence and management of pyrotinib-associated diarrhea in HER2-positive advanced breast cancer patients

被引:15
作者
Fang, Chen [1 ]
Wen, Jiahuai [1 ]
Kang, Mengling [1 ]
Zhang, Yuzhu [2 ]
Chen, Qianjun [1 ]
Ren, Liping [1 ]
机构
[1] Guangdong Hosp Tradit Chinese Med, Dept Breast Oncol, 111 Dade Rd, Guangzhou 510060, Peoples R China
[2] Shanghai Univ Tradit Chinese Med, Dept Breast Oncol, Shuguang Hosp, Shanghai, Peoples R China
关键词
Breast cancer; pyrotinib; diarrhea; EPIDERMAL-GROWTH-FACTOR;
D O I
10.21037/apm-21-3978
中图分类号
R19 [保健组织与事业(卫生事业管理)];
学科分类号
摘要
Background: The PHOEBE study showed that pyrotinib is an alternative treatment option for patients with human epidermal growth factor receptor 2 (HER2)-positive advanced breast cancer after trastuzumab and chemotherapy. Diarrhea was a common adverse event that could compromise or modify treatment administration. Methods: We conducted a retrospective cohort study of HER2-positive advanced breast cancer patients receiving a pyrotinib-based regimen between August 2018 and January 2021. The risk of diarrhea with 95% confidence limits (CLs) was calculated and management was analyzed. Results: A total of 46 HER2-positive advanced breast cancer patients were enrolled. Diarrhea of any grade occurred in 100% of patients, and grade 3 diarrhea was observed in 52.2% (n=24) of patients. Treatment dose modification was implemented in 39.1% (n=18) of advanced breast cancer patients. Compared with other treatment regimens, patients receiving pyrotinib plus vinorelbine suffered the highest risk of diarrhea (60%), though no significant difference was confirmed (P=0.77). Antidiarrheal agents were commonly used and loperamide-based regimens achieved an ideal antidiarrheal effect (95.3-100%), while non-loperamide-based regimens (such as montmorillonite powder) had a lower control rate (78.6%). Conclusions: Diarrhea was a common adverse event of pyrotinib-based treatment, and approximately 50% of patients suffered high grade diarrhea. Loperamide-based antidiarrheal agents could commendably manage most episodes.
引用
收藏
页码:210 / 216
页数:7
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