与抗癌疗法相关的 AKI:小分子和靶向治疗。

IF 3.2 Q1 UROLOGY & NEPHROLOGY
Kidney360 Pub Date : 2024-08-26 DOI:10.34067/KID.0000000566
Jaya Kala, Teresa Joseph, Marta Pirovano, Roberta Fenoglio, Laura Cosmai
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引用次数: 0

摘要

与标准的传统化疗相比,分子靶向疗法大大提高了患者的生存率,为癌症治疗带来了革命性的变化。这些药物的靶点是阻止癌细胞生长和扩散的特定分子或靶点。许多此类疗法已被批准用于乳腺癌、白血病、结肠直肠癌、肺癌和卵巢癌的治疗,并取得了显著成效。与传统化疗相比,这种疗法的优势在于能有效、高特异性地给药,同时毒性较低。虽然被称为 "靶向",但许多此类药物缺乏特异性和选择性,而且往往会抑制多个靶点,包括肾脏中的靶点。产生副作用的原因通常是正常组织中被抑制分子的靶点失调。脱靶 "效应是由于药物与非预期靶点结合造成的。靶上 "效应与对途径的抑制有关,反映了对预期药物靶点的不适当抑制或激活。早期发现和正确处理肾脏毒性对保护肾功能至关重要。对这些毒性的了解有助于指导优化和持续使用这些强效疗法。本综述总结了用于治疗癌症的不同类型的分子靶向疗法,其引起的肾毒性的发生率、严重程度和模式,以及其合理机制和治疗建议。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
AKI Associated with Anti-cancer Therapies: Small Molecules and Targeted Therapies.

Molecular targeted therapy has revolutionized cancer treatment by significantly improving the patient survival compared to standard conventional chemotherapies. The use of these drugs targets specific molecules or targets which block growth and spread of cancer cells. Many of these therapies have been approved for use with remarkable success in breast, leukemia colorectal, lung and ovarian cancers. The advantage over conventional chemotherapy is its ability to deliver drug effectively with high specificity while being less toxic. Although known as "targeted," many of these agents lack specificity and selectivity, and they tend to inhibit multiple targets including those in the kidneys. The side effects usually arise because of dysregulation of targets of the inhibited molecule in normal tissue. The "off target" effects are caused by drug binding to unintended targets. The "on target" effects are associated with inhibition towards the pathway reflecting inappropriate inhibition or activation of the intended drug target. Early detection and correct management of kidney toxicities is crucial to preserve kidney functions. The knowledge of these toxicities helps guide optimal and continued utilization of these potent therapies. This review summarizes the different types of molecular targeted therapies used in treatment of cancer, the incidence, severity and pattern of nephrotoxicity caused by them, with their plausible mechanism and proposed treatment recommendations.

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来源期刊
Kidney360
Kidney360 UROLOGY & NEPHROLOGY-
CiteScore
3.90
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