1例奥拉帕利致Ⅳ度骨髓抑制患者的药学监护

doi:10.19803/j.1672-8629.20230166

中国药物警戒 ›› 2023, Vol. 20 ›› Issue (10): 1176-1180.
DOI: 10.19803/j.1672-8629.20230166

1例奥拉帕利致Ⅳ度骨髓抑制患者的药学监护

王祺茹¹, 左丽², 杜琼^1,3,4, 叶玲¹, 阮聪¹, 翟青^1,3,4, 徐蕊^1,*

¹复旦大学附属肿瘤医院闵行院区,上海市闵行区肿瘤医院药剂科,上海 200240;
²复旦大学附属肿瘤医院闵行院区,上海市闵行区肿瘤医院肿瘤内科,上海 200240;
³复旦大学附属肿瘤医院药剂科,上海 200032;
⁴复旦大学上海医学院肿瘤学系,上海 200032

收稿日期:2023-03-23 出版日期:2023-10-15 发布日期:2023-10-16
通讯作者: ^*徐蕊,女,硕士,主管药师,肿瘤药学。E-mail: ruixu19911992@163.com
作者简介:王祺茹,女,硕士,主管药师,肿瘤药学。
基金资助:
上海市闵行区卫生健康委员会科研课题（2020MW47）; 上海市闵行区卫生健康委员会科研课题（2022MW40）; 上海市闵行区卫生健康系统优秀青年药学人才计划（mwyjyx03）

Pharmaceutical care of a patient with grade Ⅳ myelosuppression induced by olapalil

WANG Qiru¹, ZUO Li², DU Qiong^1,3,4, YE Ling¹, RUAN Cong¹, ZHAI Qing^1,3,4, XU Rui^1,*

¹Department of Pharmacy, Minhang Branch, Fudan University Cancer Hospital/Shanghai Minhang District Cancer Hospital, Shanghai 200240, China;
² Department of Oncology, Minhang Branch, Fudan University Cancer Hospital/Shanghai Minhang District Cancer Hospital, Shanghai 200240, China;
³Department of Pharmacy, Cancer Hospital Affiliated to Fudan University, Shanghai 200032, China;
⁴ Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China

Received:2023-03-23 Online:2023-10-15 Published:2023-10-16

摘要/Abstract

摘要： 目的探讨临床药师参与奥拉帕利致Ⅳ度骨髓抑制的药学干预,为临床安全合理用药提供参考。方法临床药师参与1例奥拉帕利引起的Ⅳ度骨髓抑制的药学监护及不良反应管理,通过查阅国内外文献并结合多聚腺苷二磷酸核糖聚合酶抑制剂（PARPi）的不良反应管理指南共识,对患者的不良反应症状、生化指标、凝血功能等进行定期监测评估并及时对症治疗,提出个体化用药建议。结果临床药师与医师紧密协作给予卵巢癌患者服用奥拉帕利后的不良反应管理和药学监护,协助医师优化重启治疗方案,药师随访管理患者8月余,血生化在参考值范围,肿瘤病情稳定,未再出现明显Ⅱ度及以上骨髓抑制。结论临床药师深入临床参与卵巢癌患者应用奥拉帕利维持治疗的用药监护和不良反应管理,协助医师调整个体化用药方案,可以促进患者用药合理、安全、有效。

关键词: 奥拉帕利, 卵巢癌, 骨髓抑制, 药品不良反应, 药学监护

Abstract: Objective To investigate the pharmaceutical interventions in one case olapari-induced grade Ⅳ myelopathic depression by clinical pharmacists, and to provide reference for clinical safe and rational drug use. Methods Clinical pharmacists participated in the pharmaceutical care and adverse reaction management of one case of olapari-induced grade Ⅳ myeliopathic depression, regularly monitored and assessed adverse reaction symptoms, biochemical indexes and coagulation function of the patient, initiated immediate symptomatic treatment, and recommended individualized medication by referring to domestic and foreign literature and the consensus on guidelines for management of adverse reactions caused by PARP inhibitors. Results Clinical pharmacists worked in close collaboration with physicians to administer olaparil to this ovarian cancer patient to manage her adverse reactions, and assisted physicians in optimizing and restarting the treatment plan. Pharmacists followed up this patient for more than 8 months, during which time her blood biochemistry was within the reference range, tumor condition was stable, and no obvious grade Ⅱ or above myelopathic suppression occurred again. Conclusion The involvement of clinical pharmacists in drug monitoring and adverse reaction management during olaparil maintenance therapy of ovarian cancer patients, and in adjusting individualized medication plans can promote rational, safe and effective drug use for patients.

Key words: olaparib, ovarian cancer, myelosuppression, adverse drug reaction, pharmaceutical care

中图分类号:

R971.6
R994

王祺茹, 左丽, 杜琼, 叶玲, 阮聪, 翟青, 徐蕊. 1例奥拉帕利致Ⅳ度骨髓抑制患者的药学监护[J]. 中国药物警戒, 2023, 20(10): 1176-1180.

WANG Qiru, ZUO Li, DU Qiong, YE Ling, RUAN Cong, ZHAI Qing, XU Rui. Pharmaceutical care of a patient with grade Ⅳ myelosuppression induced by olapalil[J]. Chinese Journal of Pharmacovigilance, 2023, 20(10): 1176-1180.

参考文献

[1] SIEGEL RL, MILLER KD, WAGLE NS, et al.Cancer statistics, 2023[J]. CA Cancer J Clin, 2023, 73(1): 17-48.
[2] The Gynecological Oncology Society of Chinese Medical Association. Clinical guidelines for PARP inhibitors in ovarian cancer (2022 edition)[J].Advances in Modern Obstetrics and Gynecology(现代妇产科进展), 2022, 31(8): 561-572.
[3] CHANDRASEKARAN A, ELIAS KM.Synthetic lethality in ovarian cancer[J]. Mol Cancer Ther, 2021, 20(11): 2117-2128.
[4] WANG YT, DAI YY, SUN YC, et al.Application of polyadenosine diphosphoribose polymerase inhibitors in ovarian cancer from the perspective of pharmacy[J]. Chinese Journal of New Medicine(中国新药杂志), 2021, 30(13): 1200-1206.
[5] MOORE K, COLOMBO N, SCAMBIA G, et al.Maintenance olaparib in patients with newly diagnosed advanced ovarian cancer[J]. N Engl J Med, 2018, 379(26): 2495-2505.
[6] GUO XX, WU HL, SHI HY, et al.The efficacy and safety of olaparib in the treatment of cancers: a meta-analysis of randomized controlled trials[J]. Cancer Manag Res, 2018, 10: 2553-2562.
[7] WU XH, ZHU JQ, YIN RT, et al.Niraparib maintenance therapy in patients with platinum-sensitive recurrent ovarian cancer using an individualized starting dose (NORA): a randomized, double-blind, placebo-controlled phase III trial[J]. Ann Oncol, 2021, 32(4): 512-521.
[8] The Chinese Anti-Cancer Association gynecological tumor professional committee. Chinese Guidelines for maintenance treatment of ovarian epithelial cancer (2022 edition)[J]. Chinese Journal of Practical Gynecology and Obstetrics(中国实用妇科与产科杂志), 2022, 38(1): 56-65.
[9] LAFARGUE CJ, DAL MOLIN GZ, SOOD AK, et al.Exploring and comparing adverse events between PARP inhibitors[J]. Lancet Oncol, 2019, 20(1): e15-e28.
[10] FENG Z, WU XH.Overview of hematological toxicity of PARP inhibitors for maintenance therapy in patients with platinum-sensitive recurrent ovarian cancer[J]. Chinese Journal of Cancer(中国癌症杂志), 2020, 30(4): 299-304.
[11] WANG YT, LI YF, YANG J, et al.Pharmacologic care of thrombocytopenia induced by olaparil in a patient with platinum-sensitive recurrent ovarian cancer[J]. Chinese Journal of Pharmacy(中国药学杂志), 2021, 56(20): 1659-1663.
[12] END R, O'MALLEY DM, BANERJEE S, et al. Comparative tolerability and dose modifications of poly (ADP-ribose) polymerase inhibitors in ovarian cancer: a retrospective cohort Study of US healthcare claims data[J]. Gynecol Oncol, 2021, 168(1): S116.
[13] Classification criteria for acute and subacute toxicity of anticancer drugs (WHO criteria)[J]. Cancer(癌症), 1992(3): 254.
[14] The Drug Evaluation Center of National Medical Products Administration (NMPA). Drug Instructions for Olaparil tablets[EB/OL].(2021-07-02)[2023-03-21].https://www.cde.org.cn/main/xxgk/postmarketpage?acceptidCODE=0f717ac01546f0e9228da9c6acb7ca96.
[15] WANG C, LI J.Haematologic toxicities with PARP inhibitors in cancer patients: an up-to-date meta-analysis of 29 randomized controlled trials[J]. J Clin Pharm Ther, 2021, 46(3): 571-584.
[16] Yunnan Lei Yun Shang Ideal Pharmaceutical Co. LTD.Drug description of Shenshuaining[EB/OL]. (2020-12-30)[2023-03-21]. http://www.ynlxyy.cn/view/mxsqpc/7/480/view/1489.html.
[17] NARANJO CA, SHEAR NH, LANCTOT KL.Advances in the diagnosis of adverse drug reactions[J]. Journal of Clinical Pharmacology, 1992, 32(10): 897-904.
[18] The Gynecological Oncology Professional Committee of Chinese Anti-Cancer Association. Chinese expert Consensus on adverse reaction Management of PARP inhibitors (2021 edition)[J]. Chinese Journal of Gynecology and Obstetrics(中国实用妇科与产科杂志), 2021, 37(11): 1119-1130.
[19] The Hematology Society of Chinese Medical Association. Chinese guidelines for diagnosis and treatment of myelodysplastic syndrome (2019)[J]. Chinese Journal of Hematology(中华血液学杂志), 2019(2): 89-97.
[20] National Comprehensive Cancer Network. NCCN Clinical practice guidelines in oncology: Ovarian Cancer Including Fallopian Tube Cancer and Primary Peritoneal Cancer.Version1, 2023[EB/OL].(2022-12-22)[2023-03-21]. https://www.nccn.org/professionals/physician_gls/pdf/ovarian.pdf.
[21] The Chinese Society of Clinical Oncology. Guidelines for Diagnosis and Treatment of Ovarian Cancer(卵巢癌诊疗指南)[M]. Beijing: People's Medical Publishing House, 2022.
[22] POVEDA A, FLOQUET A, LEDERMANN JA, et al.Olaparib tablets as maintenance therapy in patients with platinum-sensitive relapsed ovarian cancer and a BRCA1/2 mutation (SOLO2/ENGOT-Ov21): a final analysis of a double-blind, randomised, placebo-controlled, phase 3 trial[J]. Lancet Oncol, 2021, 22(5): 620-631.
[23] The Chinese Society of Clinical Oncology. Clinic hematologic toxicities with PARP inhibitors in cancer patients: an up-to-date al Practice Guidelines for tumor-associated anemia (肿瘤相关性贫血临床实践指南)[M]. Beijing: People's Medical Publishing House, 2022.
[24] The Chinese Society of Clinical Oncology. Guidelines for diagnosis and treatment of thrombocytopenia due to tumor therapy(肿瘤治疗所致血小板减少症诊疗指南)[M]. Beijing: People's Medical Publishing House, 2022.
[25] The Oncology Support Rehabilitation Therapy Group of Chinese Medical Association Oncology Society. Expert consensus on clinical management of tumor-treatment-related thrombocytopenia[J]. Oncology(肿瘤), 2021, 41(12): 812-827.
[26] The Chinese Society of Clinical Oncology (CSCO). Standardized Management guidelines for tumor chemorotherapy-associated neutropenia (2021)[J]. Journal of Clinical Oncology(临床肿瘤学杂志), 2021, 26(7): 638-648.
[27] National Comprehensive Cancer Network. NCCN clinical practice guidelines in oncology: hematopoietic growth factors. Version2, 2023[EB/OL]. (2022-12-02)[2023-03-21].https://www.nccn.org/professionals/physician_gls/pdf/growthfactors.pdf.
[28] TEW WP, LACCHETTI C, ELLIS A, et al.PARP inhibitors in the management of ovarian cancer: ASCO guideline[J]. Journal of Clinical Oncology, 2020, 38(30): 3468-3493.
[29] LIU BH, SHEN AZ, SU D.Pharmaceutical care of a case of severe myelopathic depression caused by meropenem for injection combined with vancomycin for injection[J]. Chinese Journal of Pharmacovigilance(中国药物警戒), 2023, 20(3): 339-342.
[30] FRANCIS KE, KIM SI, FRIEDLANDER M, et al.The impact of olaparib dose reduction and treatment interruption on treatment outcome in the SOLO2/ENGOT-ov21 platinum-sensitive recurrent ovarian cancer[J]. Ann Oncol, 2022, 33(6): 593-601.
[31] GUO T, YIN RT.Adverse reactions and management of polyadenosine diphosphate ribose polymerase inhibitors for maintenance therapy of advanced ovarian cancer[J]. Oncology Pharmacy(肿瘤药学), 2021, 11(3): 263-279.
[32] XU XY, ZHANG QB, XIAO HT, et al.Research progress of the effect of timing of intake on the bioavailability of oral antitumor drugs[J]. Oncology Pharmacy(肿瘤药学), 2022, 12(1): 28-35.
[33] REN XY, CONG MH.Food and drug interactions[J/OL]. Journal of Tumor Metabolism and Nutrition Electronic(肿瘤代谢与营养电子杂志), 2019, 6(1): 7-12.

1例奥拉帕利致Ⅳ度骨髓抑制患者的药学监护

Pharmaceutical care of a patient with grade Ⅳ myelosuppression induced by olapalil

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