药事实战|靶向和免疫治疗遇上肾功能不全，该如何调整使用剂量及方案？

表中引用指南和文献（按照字母顺序排列）：

[1]  Gibbons et al. Phase I and

pharmacokinetic study of imatinib mesylate in patients with advanced malignancies andvarying degrees of renal dysfunction: a study by the National CancerInstitute Organ Dysfunction Working Group.

[2] Iddawela et al. Safety and efficacy of vemurafenib in end stage renal failure.

[3]Imai et al. Successful afatinib treatment of advancednon-small-cell lung cancer patients undergoing hemodialysis.

[4]Miller et al. Phase I and pharmacokinetic study ofsorafenib in patients with hepatic or renal dysfunction: CALGB 60301.

[5]Masini et al. Use of tyrosine kinase inhibitors inpatients with metastatic kidney cancer receiving haemodialysis: aretrospective Italian survey.

[6]Park et al. Pharmacokinetics of dabrafenib in a patientwith metastatic melanoma undergoing haemodialysis.

[7]Weil et al. Pharmacokinetics of vandetanib in subjectswith renal or hepatic impairment.

表中缩写：

CCO:加拿大安大略癌症治疗中心

USPI：美国处方信息

NMPA：国家药品监督管理局

ALK：间变性淋巴瘤激酶

BCL-2：B淋巴细胞瘤-2基因

BTK：布鲁顿酪氨酸激酶

EGFR：表皮生长因子

HER2：人表皮生长因子受体2

MEK：丝裂原活化细胞外激酶

mTOR：西罗莫司机能靶点

PARP：聚腺苷二磷酸核糖聚合酶

TLS：肿瘤溶解综合征

VEGF：血管内皮生长因子