内容紹介
Hange-Shashin-To for Preventing Diarrhea during Afatinib Therapy
Summury
Afatinib is an epidermal growth factor receptor-tyrosine kinase inhibitor(EGFR-TKI). In a randomized phase Ⅲ study(Lux-Lung 3 study)employing patients harboring EGFR mutations, patients administered afatinib show a significantly longer progression free survival time(PFS)than those administered combination chemotherapy comprising cisplatin and pemetrexed. However, most of the patients(95.2%)treated with afatinib experienced diarrhea. In the present report, 16 patients with EGFR mutations were treated by afatinib at our institution from May 2014 to December 2014. Twelve patients were administered a diarrhea prevention herbal medicine, Hange-shashin-to. Seven of 12 patients(58%)had no diarrhea during the 28 days of therapy. All 4 of the patients who did not receive Hange-shashin-to experienced diarrhea above Grade 1 within 6 days of starting therapy. The rate of diarrhea differed significantly between the patients receiving and not receiving Hange-shashin-to. In conclusion, preventive administration of Hange-shashin-to may reduce the occurrence of diarrhea during afatinib treatment.
要旨
EGFR遺伝子変異陽性非小細胞肺癌患者に対し,アファチニブ(afatinib,商品名: ジオトリフ)は化学療法群(PEM+CDDP群)に対する無増悪生存期間の延長効果を示したが(Lux-Lung 3国際共同第Ⅲ相臨床試験),高頻度の下痢が発生した(全Grade 95.2%)。当院で2014年5月～12月の間に,16名のEGFR遺伝子変異陽性非小細胞肺癌患者に対しアファチブを使用した。そのうち12名に下痢予防として半夏瀉心湯が併用された。うち7名(58%)では内服開始後28日以内に下痢を発症しなかった。一方,半夏瀉心湯を併用しなかった4名全例でアファチニブ内服開始から6日以内にGrade 1以上の下痢を認めた。半夏瀉心湯併用の有無で下痢発症に有意差を認めた(p=0.042)。アファチニブによる下痢に対し半夏瀉心湯の併用は,有効な予防法である可能性がある。
目次
Summury
Afatinib is an epidermal growth factor receptor-tyrosine kinase inhibitor(EGFR-TKI). In a randomized phase Ⅲ study(Lux-Lung 3 study)employing patients harboring EGFR mutations, patients administered afatinib show a significantly longer progression free survival time(PFS)than those administered combination chemotherapy comprising cisplatin and pemetrexed. However, most of the patients(95.2%)treated with afatinib experienced diarrhea. In the present report, 16 patients with EGFR mutations were treated by afatinib at our institution from May 2014 to December 2014. Twelve patients were administered a diarrhea prevention herbal medicine, Hange-shashin-to. Seven of 12 patients(58%)had no diarrhea during the 28 days of therapy. All 4 of the patients who did not receive Hange-shashin-to experienced diarrhea above Grade 1 within 6 days of starting therapy. The rate of diarrhea differed significantly between the patients receiving and not receiving Hange-shashin-to. In conclusion, preventive administration of Hange-shashin-to may reduce the occurrence of diarrhea during afatinib treatment.
要旨
EGFR遺伝子変異陽性非小細胞肺癌患者に対し,アファチニブ(afatinib,商品名: ジオトリフ)は化学療法群(PEM+CDDP群)に対する無増悪生存期間の延長効果を示したが(Lux-Lung 3国際共同第Ⅲ相臨床試験),高頻度の下痢が発生した(全Grade 95.2%)。当院で2014年5月～12月の間に,16名のEGFR遺伝子変異陽性非小細胞肺癌患者に対しアファチブを使用した。そのうち12名に下痢予防として半夏瀉心湯が併用された。うち7名(58%)では内服開始後28日以内に下痢を発症しなかった。一方,半夏瀉心湯を併用しなかった4名全例でアファチニブ内服開始から6日以内にGrade 1以上の下痢を認めた。半夏瀉心湯併用の有無で下痢発症に有意差を認めた(p=0.042)。アファチニブによる下痢に対し半夏瀉心湯の併用は,有効な予防法である可能性がある。