Ognerubov NA. Efficacy of concomitant therapy with ademetionine in antitumor drug therapy: A review. Consilium Medicum. 2024;26(6):351–361. DOI: 10.26442/20751753.2024.6.202857
Эффективность сопроводительной терапии адеметионином при проведении противоопухолевой лекарственной терапии
Огнерубов Н.А. Эффективность сопроводительной терапии адеметионином при проведении противоопухолевой лекарственной терапии. Consilium Medicum. 2024;26(6):351–361.
DOI: 10.26442/20751753.2024.6.202857
Ognerubov NA. Efficacy of concomitant therapy with ademetionine in antitumor drug therapy: A review. Consilium Medicum. 2024;26(6):351–361. DOI: 10.26442/20751753.2024.6.202857
Повреждения печени, вызванные лекарственной противоопухолевой терапией, представляют частое заболевание у больных, страдающих злокачественными новообразованиями. Это обусловлено внедрением в лечебный процесс новых инновационных препаратов, существенно увеличивающих продолжительность и качество жизни, но также и частоту побочных эффектов с поражением печени различной степени тяжести. Диапазон гепатотоксичности при проведении химиотерапии колеблется от 5 до 100%. Спектр морфологических изменений печени при этом многообразен, характеризуется развитием острого и хронического поражения печени с повреждением гепатоцитов и исходом в фиброз. Рассмотрены клинические особенности диагностики различных типов, вариантов и фенотипов лекарственно-индуцированного повреждения печени при химиотерапии солидных опухолей и гемобластозов. Статья содержит обзор литературы, посвященной вопросам сопроводительной терапии с применением адеметионина с целью уменьшения метаболических нарушений, печеночной токсичности, обусловленной проведением цитотоксической терапии. Клинические и биохимические эффекты при этом сохраняются длительно по окончании лечения. Подробно изложены результаты применения адеметионина в коррекции клинических симптомов, таких как усталость. Представленные материалы позволят практическим врачам пересмотреть роль сопроводительной терапии с использованием адеметионина для предупреждения и уменьшения проявлений гепатотоксичности, индуцированной полихимиотерапией. Такое решение позволяет реализовать персонализированный подход к пациентам со злокачественными заболеваниями, тем самым значимо улучшить медицинскую помощь, а также увеличить продолжительность и качество жизни.
Liver injury caused by antitumor therapy is a common disorder in patients with malignancies. It is due to the introduction of new innovative drugs into the treatment, which significantly increases the duration and quality of life, but also the frequency of side effects with liver damage of varying severity. The rate of hepatotoxicity during chemotherapy ranges from 5% to 100%. The spectrum of morphological changes in the liver is diverse and includes acute and chronic liver injury with damage to hepatocytes and outcome in fibrosis. The clinical features of the diagnosis of various types, variants, and phenotypes of drug-induced liver injury in the chemotherapy of solid tumors and hematological malignancies are addressed. The article reviews the literature on concomitant treatment with ademetionine to reduce metabolic disorders and hepatic toxicity caused by cytotoxic therapy. Clinical and biochemical effects persist for a long time after treatment. The results of using ademetionine to correct clinical symptoms such as fatigue are described in detail. The presented data supports a practical revision of the role of concomitant therapy with ademetionine to prevent and reduce the manifestations of hepatotoxicity induced by polychemotherapy. This approach contributes to a personalized approach to patients with malignancies, thereby significantly improving medical care and increasing the duration and quality of life.
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1. Mehta N, Ozick LA, Lisa Anne Ozck, Gbadehan E. Drug-Induced Hepatotoxicity. Jul 08, 2022. Available at: https://emedicine.medscape.com/article/169814-overview?form=fpf. Accessed: 28.04.2024.
2. Björnsson ES, Bergmann OM, Björnsson HK, et al. Incidence, Presentation, and Outcomes in Patients With Drug-Induced Liver Injury in the General Population of Iceland. Gastroenterology. 2013;144(7):1419-25, 1425.e1-3; quiz e19-20. DOI:10.1053/j.gastro.2013.02.006
3. Reporting adverse drug reactions definitions of terms and criteria for their use. Geneva: CIOMS, 1999. 146 p.
4. Periáñez-Párraga L, Martínez-López I, Ventayol-Bosch P, et al. Drug dosage recommendations in patients with chronic liver disease. Rev Esp Enferm Dig.
2012;104(4):165-84. DOI:10.4321/s1130-01082012000400002
5. Mudd TW, Guddati AK. Management of hepatotoxicity of chemotherapy and targeted agents. Am J Cancer Res. 2021;11(7):3461-74.
6. Colsky J, Greenspan EM, Warren TN. Hepatic fibrosis in children with acute leukemia after therapy with folic acid antagonists. AMA Arch Pathol. 1955;59:198-206.
7. Hoofnagle JH, Björnsson ES. Drug-Induced Liver Injury – Types and Phenotypes. N Engl J Med. 2019;381(3):264-73. DOI:10.1056/NEJMra1816149
8. Sharma A, Houshyar R, Bhosale P, et al. Chemotherapy induced liver abnormalities: an imaging perspective. Clin Mol Hepatol. 2014;20(3):317-26. DOI:10.3350/cmh.2014.20.3.317
9. European Association for the Study of the Liver. EASL Clinical Practice Guidelines: Drug-Induced Liver Injury. J Hepatol. 2019;70(6):1222-61. DOI:10.1016/j.jhep.2019.02.014
10. Almutairi AR, McBride A, Slack M, et al. Potential Immune-Related Adverse Events Associated With Monotherapy and Combination Therapy of Ipilimumab, Nivolumab, and Pembrolizumab for Advanced Melanoma: A Systematic Review and Meta-Analysis. Front Oncol. 2020;10:91. DOI:10.3389/fonc.2020.00091
11. Cho YA, Han JM, Kang SY, et al. Analysis of Risk Factors for Hepatotoxicity Induced by Immune Checkpoint Inhibitors. J Immunother. 2021;44(1):16-21. DOI:10.1097/CJI.0000000000000347
12. Larkin J, Chiarion-Sileni V, Gonzalez R, et al. Combined Nivolumab and Ipilimumab or Monotherapy in Untreated Melanoma. N Engl J Med. 2015;373(1):23-34. DOI:10.1056/NEJMoa1504030
13. Wang DY, Salem JE, Cohen JV, et al. Fatal Toxic Effects Associated With Immune Checkpoint Inhibitors: A Systematic Review and Meta-analysis. JAMA Oncol. 2018;4(12):1721-8. DOI:10.1001/jamaoncol.2018.3923
14. Wolchok JD, Neyns B, Linette G, et al. Ipilimumab monotherapy in patients with pretreated advanced melanoma: a randomised, double-blind, multicentre, phase 2, dose-ranging study. Lancet Oncol. 2010;11(2):155-64. DOI:10.1016/S1470-2045(09)70334-1
15. Cohen JV, Dougan M, Zubiri L, et al. Liver biopsy findings in patients on immune checkpoint inhibitors. Mod Pathol. 2021;34(2):426-37. DOI:10.1038/s41379-020-00653-1
16. Thomas R, Sebastian B, George T, et al. A review of the imaging manifestations of immune check point inhibitor toxicities. Clin Imaging. 2020;64:70-9. DOI:10.1016/j.clinimag.2020.04.007
17. Tsung I, Dolan R, Lao CD, et al. Liver injury is most commonly due to hepatic metastases rather than drug hepatotoxicity during pembrolizumab immunotherapy. Aliment Pharmacol Ther. 2019;50(7):800-8. DOI:10.1111/apt.15413
18. Andrade RJ, Lucena MI, Fernández MC, et al. Drug-induced liver injury: an analysis of 461 incidences submitted to the Spanish registry over a 10-year period. Gastroenterology. 2005;129(2):512-21.
19. Shen T, Liu Y, Shang J, et al. Incidence and Etiology of Drug-Induced Liver Injury in Mainland China. Gastroenterology. 2019;156(8):2230-41.e11. DOI:10.1053/j.gastro.2019.02.002
20. Benić MS, Nežić L, Vujić-Aleksić V, Mititelu-Tartau L. Novel Therapies for the Treatment of Drug-Induced Liver Injury: A Systematic Review. Front Pharmacol. 2022;12:785790. DOI:10.3389/fphar.2021.785790
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Авторы
Н.А. Огнерубов*
Пензенский институт усовершенствования врачей – филиал ФГБОУ ДПО «Российская медицинская академия непрерывного профессионального образования» Минздрава России, Пенза, Россия
*ognerubov_n.a@mail.ru
________________________________________________
Nikolai A. Ognerubov*
Penza Institute for Advanced Training of Physicians – branch of the Russian Medical Academy of Continuous Professional Education, Penza, Russia
*ognerubov_n.a@mail.ru