最新研究发现的克里唑替尼副作用

halfdome

新闻链接：
http://www.news-medical.net/news ... sterone-levels.aspx

论文原文：
“Rapid-onset hypogonadism secondary to crizotinib use in men with metastatic nonsmall cell lung cancer”
http://onlinelibrary.wiley.com/doi/10.1002/cncr.27450/full

Published in:
Cancer (美国癌症协会刊物）
Volume 118, Issue 21, pages 5302–5309, 1 November 2012

论文Abstract部分如下

注：本人非生化、医学专业人士，错误在所难免，仅供参考。欢迎指正。

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背景：
本文研究了应用crizotinib治疗和未经crizotinib治疗的已转移NSCLC患者间睾丸激素（Testosterone）水平的变化。

方法：
检测了19例应用crizotinib治疗和19例未经crizotinib治疗的的转移NSCLC男性患者的睾丸激素水平。对患者的临床特征进行比较，相应病例进行的其他荷尔蒙化验。对2例开始服用crizotinib的病例，4例有中断用药的病例，和已经停药的病例进行了连续的荷尔蒙检测，以记录应用和停用crizotinib时的动态荷尔蒙变化。

结果：
所有19例（100%）经crizotinib治疗的男性患者的睾丸激素（T）水平降低(<241 ng/dL)，未经crizotinib治疗的19例患者中有6例（32%）T水平降低(<241 ng/dL)。(平均值分别为 131 ng/dL 和 311 ng/dL，P=.0002)。在ALK融合且还未经crizotinib治疗的5例患者中只有1例存在T水平降低的情况。2例之前T水平正常并开始crizotinib治疗的病例在14-21天出现快速睾丸激素，黄体生成激素，和促卵泡素水平的降低。停用crizotinib后T水平可恢复正常。

结论：
应用crizotinib治疗快速导致男性患者的T水平降低。检测结果说明存在中心作用点（下丘脑或脑垂体），也有直接作用于睾丸的可能性。需要进一步的研究以评估T水平降低和crizotinib副作用的关联，并确定分子机理和药物毒性作用点。

richard666

有病人有心脏功能暂时的影响, 心律降低很多, 血压降低. 长期吃应该是不太安全.

jaydad

this is from my own notebook.  I had 3), 4), 5), 6), 7)

My lowest Testosterone was 98 ng/dL, one year ago - after 22 months on crizotinib. That was very very low.  Normal range for man of my age group (45-50) is 240-800 ng/dL.  Considering normal T range for adult women is 15-70 ng/dL, I was more a woman than a man.  And, that's true too as I have been raising my children on my own, alone, while dealing with terminal cancer.  The research paper's author was Dr Ross Camidge, my doctor in Denver, Colorado.  Two weeks ago, we talked about this again.  He said he sent all the data to Pfizer, suggesting that Pfizer should put a warning label on crizotinib, because low T can lead to some serious health problems in both men and women besides loss of sexual desire, but Pfizer people totally ignored him.  Earning $profit is always more important than protecting patients, to drug companies.  

crizotinib/ Xalkori side effects

1) constipation
2) lower heart rate
3) leg edema, arm and hands edema, maybe even face
4) taste change, loss of apetite
5) elevated liver enzymes, AP,ALT,AST
6) low testosterone in men, hot flash in women
7) kidney problem: "hydronephrosis" - maybe only me

8) light-headness, diziness
9) fatigue
10) mild skin rach or eczema on face and arms, some itching
11) indigestion, stomach problem
12)  joint pain
13) trouble sleeping
14) cold symptoms, running nose, stuff airway, sore throat
15) numbness or tingling
16) vomitting, and diarrhea, in the beginning.  Diarrhea becomes ocassional or just loose stool, or disappears later

定江定海

jaydad 发表于 2013-7-17 11:20
this is from my own notebook.  I had 3), 4), 5), 6), 7)

My lowest Testosterone was 98 ng/dL, one  ...

great father

定江定海

jaydad 发表于 2013-7-17 11:20
this is from my own notebook.  I had 3), 4), 5), 6), 7)

My lowest Testosterone was 98 ng/dL, one  ...

great father