新的多发性骨髓瘤治疗方案的实用指南:护理的角度

IF 3 3区 医学 Q2 ONCOLOGY
Monica Epstein , Candis Morrison
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引用次数: 0

摘要

与实体瘤的情况一样,多发性骨髓瘤(MM)患者的治疗模式已经从非特异性化疗药物转向新型靶向药物。目前,多种靶向治疗可用于治疗患者,增加了治疗方式的武库,包括化疗,免疫治疗,放射治疗,造血干细胞移植(HSCST)和嵌合抗原t细胞治疗(CAR-T)。这些新颖的靶向药物极大地增加了患者的乐观情绪,他们现在可以连续治疗多年。幸运的是,我们的患者可以使用这些新疗法,但这一优势与安全交付这些疗法的挑战并存。虽然就反应率和生存而言,每一类药物都显示出疗效,但它们也会产生一类效应,从而构成毒性风险。此外,新一代药剂在类中往往有轻微不同的毒性概况比他们的前辈。这些因素必须被多学科团队处理,并且它们的风险必须被减轻。这篇综述概述了MM药物开发的演变。对于每一种靶向药物,介绍了关键试验的疗效数据和在试验中证明的风险重点,以及在上市后监测期间。描述了与类中的代理相关的特定风险,这些风险不是与所有新类成员共享的。表中列出了这些潜在的风险,并推荐了减轻毒性的护理措施,作为护士在计划和提供病人护理时可以使用的快速参考。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Practical guidance for new multiple myeloma treatment regimens: A nursing perspective

As is the case for solid tumors, treatment paradigms have shifted from non-specific chemotherapeutic agents towards novel targeted drugs in the treatment of patients with multiple myeloma (MM). Currently, multiple targeted therapies are available to treat patients augmenting the arsenal of modalities which also includes chemotherapy, immunotherapy, radiation therapy, hematopoietic stem cell transplantation (HSCST) and chimeric antigen T-cell therapy (CAR-T). These novel, targeted agents have dramatically increased optimism for patients, who may now be treated over many years with successive regimens. As fortunate as we are to have these new therapies available for our patients, this advantage is juxtaposed with the challenges involved with delivering them safely. While each class of agents has demonstrated efficacy, in terms of response rates and survival, they also exert class effects which pose risks for toxicity. In addition, newer generation agents within the classes often have slightly different toxicity profiles than did their predecessors. These factors must be addressed, and their risks mitigated by the multidisciplinary team. This review presents a summary of the evolution of drug development for MM. For each targeted agent, the efficacy data from pivotal trials and highlights of the risks that were demonstrated in trials, as well as during post-marketing surveillance, are presented. Specific risks associated with agents within the classes, that are not shared with all new class members, are described. A table presenting these potential risks, with recommended nursing actions to mitigate toxicity, is provided as a quick reference that nurses may use during the planning, and provision, of patient care.

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来源期刊
Seminars in oncology
Seminars in oncology 医学-肿瘤学
CiteScore
6.60
自引率
0.00%
发文量
58
审稿时长
104 days
期刊介绍: Seminars in Oncology brings you current, authoritative, and practical reviews of developments in the etiology, diagnosis and management of cancer. Each issue examines topics of clinical importance, with an emphasis on providing both the basic knowledge needed to better understand a topic as well as evidence-based opinions from leaders in the field. Seminars in Oncology also seeks to be a venue for sharing a diversity of opinions including those that might be considered "outside the box". We welcome a healthy and respectful exchange of opinions and urge you to approach us with your insights as well as suggestions of topics that you deem worthy of coverage. By helping the reader understand the basic biology and the therapy of cancer as they learn the nuances from experts, all in a journal that encourages the exchange of ideas we aim to help move the treatment of cancer forward.
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