毒理性
在卡巴他赛用于转移性前列腺癌的临床试验和开放标签研究中,血清酶升高通常没有提及,肝不良事件并未出现在严重不良事件列表中。卡巴他赛的产品标签指出,血清ALT和AST升高超过5倍ULN的发生率在治疗患者中不到1%。卡巴他赛并未与明显黄疸的特异质、临床显著肝损伤的实例明确相关。
卡巴他赛与急性超敏反应有关,这些反应通常发生在初始输注时,很少在随后的给药中出现。急性超敏反应也发生在其他紫杉烷类(多西他赛和紫杉醇)上,这些反应可能很严重,导致急性肝坏死、多器官衰竭和死亡。尽管卡巴他赛尚未有类似的反应报告,但其使用受到了限制。因此,卡巴他赛并未与明显黄疸的特异质、临床显著肝损伤的实例明确相关,但已发现可引起急性超敏反应,这些反应有可能导致急性肝坏死(如同多西他赛和紫杉醇)。
可能性评分:E*(未经证实,但疑似罕见的原因,导致临床显著肝损伤)。
In the clinical trials and open label studies of cabazitaxel in metastatic prostate cancer, serum enzyme elevations were usually not mentioned and hepatic adverse events did not appear in lists of serious adverse events. The product label for cabazitaxel states that elevations of serum ALT and AST above 5 times ULN occur in less than 1% of treated patients. Cabazitaxel has not been linked convincingly to instances of idiosyncratic, clinically apparent liver injury with jaundice.
Cabazitaxel has been linked to acute hypersensitivity reactions that typically occur with the initial infusions and rarely with subsequent administration. Acute hypersensitivity reactions occur with the other taxanes (docetaxel and paclitaxel) which can be severe and lead to acute hepatic necrosis, multiorgan failure and death. While similar reactions have not been reported with cabazitaxel, its use has been limited. Thus, cabazitaxel has not been linked to instances of idiosyncratic, clinically apparent liver injury, but has been found to cause acute hypersensitivity reactions which have the potential to lead to acute hepatic necrosis (as have docetaxel and paclitaxel).
Likelihood score: E* (unproven, but suspected rare cause of clinically apparent liver injury).
来源:LiverTox