有發現搜尋框不一樣嗎？切換AI模式，讓「AI助理托特」成為你的新夥伴！ Target Therapy for Lung Cancer in Dialysis Patients 癌症在近41年來一直是台灣十大死因的第一名，而其中肺癌的死亡率又是癌症死因的第一名，每年大約有將近一萬人因肺癌而死亡，以往末期肺癌的治療以化學治療為主，然而治療效果往往有限，其存活時間的中位數約8-10個月。近幾年來的研究發現，肺癌病患往往帶有特定的驅動基因變異而造成癌症不斷增生轉移變大，這些基因變異在東西方大不相同，目前肺癌的治療已經走到精準醫療的世代，如果可以測到肺癌驅動基因變異，便可以針對這些驅動基因來設計藥物治療，也就是標靶藥物，常見肺癌的標靶藥物包括各種不同的表皮生長因子受體酪胺酸激酶抑制劑（epidermal growth factor receptor - tyrosine kinase inhibitor, EGFR TKI），間變性淋巴瘤激酶抑制劑（anaplastic lymphoma kinase inhibitor, ALK inhibitor）等。這些治療的進展讓這些末期肺癌的病患的治療有很長足的進步。另外，為了臨床試驗方便或便於使用，這些標靶藥物往往是固定劑量（Fixed dose）。然而，關於這些藥物使用在透析患者的適當劑量，目前並無相關研究，只有零星的個案報告。考慮到台灣的透析盛行率，於2018年約每百萬人口3,587人，並且隨著人口老化，盛行率逐年上升，這些病患也有可能會罹患肺癌。因此，本文將針對透析病患者標靶藥物的效應及安全性等做整理，希望能有較明確的治療實證供臨床使用。

Cancer has been the top cause of death in Taiwan for decades and the mortality rate of lung cancer is the first one. For patient with advanced lung cancer, chemotherapy was used to be the main treatment but only leads to a very short overall survival around 8-10 months. In recent years, genetic driver alterations in patients with non-small cell lung cancer (NSCLC) were identified, many target agents were designed for the driver mutations accordingly, the process was referred as precision medicine. The most common targeted therapies in lung cancer included epidermal growth factor receptor - tyrosine kinase inhibitor (EGFR TKI), Anaplastic lymphoma kinase inhibitor (ALK inhibitor), and ROS-1 inhibitor. Furthermore, prospectively randomized controlled studies of these target drugs had taken a fixed dosage and almost excluded all patients with severe renal impairment (eGFR <30mL/min/1.73 m^2). Hence, the safety and efficacy of TKIs usage in patients with severe renal impairment, or even in patients undergoing hemodialysis is still controversial. In addition, high prevalence of end stage renal disease (ESRD) was noticed in Taiwan and those patients on dialysis may also suffer from lung cancers. The aim of the present study is to share our case experience, address a mini but comprehensive review and discuss the effects of pharmacokinetic variability of these targeted drugs in dialysis patients. We hope the review could provide a good reference for clinicians. 為了持續優化網站功能與使用者體驗，本網站將Cookies分析技術用於網站營運、分析和個人化服務之目的。 若您繼續瀏覽本網站，即表示您同意本網站使用Cookies。