\u5965\u897f\u66ff\u5c3c\u8bf4\u660e\u4e66<\/p>\n
<\/p>\n
\u5546\u54c1\u540d\u79f0: LuciOsim<\/p>\n
\u751f\u4ea7\u5546:\u00a0\u00a0\u5362\u4fee\u65af\u5236\u836f\u00a0Lucius<\/p>\n
\u4e2d\u6587\u540d\u79f0:\u00a0\u5965\u897f\u66ff\u5c3c<\/p>\n
\u82f1\u6587\u540d\u79f0: \u00a0Osimertinib<\/p>\n
\u836f\u54c1\u6279\u51c6\u6587\u53f7: \u00a005 L 0971\/23<\/p>\n
<\/p>\n
<\/p>\n
\u3010\u6982\u62ec\u3011<\/p>\n
Osimertinib\u5c5e\u4e8e\u65b0\u578bEGFR-TKI\uff0c\u4e0eEGFR\u67d0\u4e9b\u7a81\u53d8\u4f53\uff08T790M\u3001L858R\u548c\u5916\u663e\u5b5019\u7f3a\u5931\uff09\u4e0d\u53ef\u9006\u6027\u7ed3\u5408\u7684\u6d53\u5ea6\u8f83\u91ce\u751f\u578b\u4f4e\u7ea69\u500d\u3002\u53e3\u670dOsimertinib\u540e\uff0c\u5728\u8840\u6d46\u4e2d\u53d1\u73b0\u4e24\u79cd\u5177\u6709\u836f\u7406\u5b66\u6d3b\u6027\u7684\u4ee3\u8c22\u4ea7\u7269(AZ7550\u548cAZ5104\uff0c\u7ea6\u5360\u539f\u5f62\u5316\u5408\u7269\u768410\uff05)\uff0c\u5176\u6291\u5236\u4f5c\u7528\u7279\u5f81\u4e0eOsimertinib\u76f8\u4f3c\u3002AZ7550\u7684\u6548\u529b\u4e0eOsimertinib\u76f8\u4f3c\uff0c\u800cAZ5104\u5bf9EGFR\u5916\u663e\u5b5019\u7f3a\u5931\u548cT790M\u7a81\u53d8(\u7ea68\u500d)\u53ca\u91ce\u751f\u578b(\u7ea615\u500d)\u7684\u6d3b\u6027\u8f83\u5f3a\u3002\u4f53\u5916\u8bd5\u9a8c\u663e\u793a\uff0c\u5728\u4e34\u5e8a\u6d53\u5ea6\u4e0b\uff0cOsimertinib\u8fd8\u53ef\u6291\u5236HER2\u3001HER3\u3001HER4\u3001ACK1\u548cBLK\u7684\u6d3b\u6027\u3002<\/p>\n
<\/p>\n
\u3010\u9002\u5e94\u75c7\u3011<\/p>\n
\u5965\u897f\u66ff\u5c3c\u9002\u7528\u4e8e\u65e2\u5f80\u7ecf\u8868\u76ae\u751f\u957f\u56e0\u5b50\u53d7\u4f53(EGFR)\u916a\u6c28\u9178\u6fc0\u9176\u6291\u5236\u5242(TKI)\u6cbb\u7597\u65f6\u6216\u6cbb\u7597\u540e\u51fa\u73b0\u75be\u75c5\u8fdb\u5c55\uff0c\u5e76\u4e14\u7ecf\u68c0\u6d4b\u786e\u8ba4\u5b58\u5728EGFRT790M\u7a81\u53d8\u9633\u6027\u7684\u5c40\u90e8\u665a\u671f\u6216\u8f6c\u79fb\u6027\u975e\u5c0f\u7ec6\u80de\u6027\u80ba\u764c(NSCLC)\u6210\u4eba\u60a3\u8005\u7684\u6cbb\u7597\u3002<\/p>\n
<\/p>\n
\u3010\u89c4\u683c\u3011<\/p>\n
80mg\/\u7247\u00a030\u7247\/\u76d2<\/p>\n
<\/p>\n
\u3010\u8d2e\u5b58\u3011<\/p>\n
\u8d2e\u5b58\u4e8e20\u00b0C\uff5e25\u00b0C (68\u00b0C\uff5e77\u00b0F)\uff1b\u5141\u8bb8\u8303\u56f4\u4e3a15\uff5e30\u00b0C (59\u201386\u00b0F)\u6e29\u5ea6\u6761\u4ef6\u4e0b\u77ed\u9014\u8fd0\u8f93\u3002<\/p>\n
<\/p>\n
\u3010\u00a0\u7528\u6cd5\u7528\u91cf\u3011<\/p>\n
\u5965\u897f\u66ff\u5c3c\u7684\u63a8\u8350\u5242\u91cf\u4e3a\u6bcf\u65e580mg\uff0c\u76f4\u81f3\u75be\u75c5\u8fdb\u5c55\u6216\u51fa\u73b0\u65e0\u6cd5\u8010\u53d7\u7684\u6bd2\u6027\u3002<\/p>\n
\u5982\u679c\u6f0f\u670d\u5965\u897f\u66ff\u5c3c1\u6b21\uff0c\u5219\u5e94\u8865\u670d\u5965\u897f\u66ff\u5c3c\uff0c\u9664\u975e\u4e0b\u6b21\u670d\u836f\u65f6\u95f4\u572812\u5c0f\u65f6\u4ee5\u5185\u3002<\/p>\n
\u5965\u897f\u66ff\u5c3c\u5e94\u5728\u6bcf\u65e5\u76f8\u540c\u7684\u65f6\u95f4\u670d\u7528\uff0c\u8fdb\u9910\u6216\u7a7a\u8179\u65f6\u670d\u7528\u5747\u53ef\u3002<\/p>\n
<\/p>\n
\u5242\u91cf\u8c03\u6574<\/p>\n
\u6839\u636e\u60a3\u8005\u4e2a\u4f53\u7684\u5b89\u5168\u6027\u548c\u8010\u53d7\u6027\uff0c\u53ef\u6682\u505c\u7528\u836f\u6216\u51cf\u91cf\u3002\u5982\u679c\u9700\u8981\u51cf\u91cf\uff0c\u5219\u5242\u91cf\u5e94\u51cf\u81f340mg\uff0c\u6bcf\u65e51\u6b21\u3002<\/p>\n
<\/p>\n
\u3010\u7981\u5fcc\u75c7\u3011<\/p>\n
\u5bf9\u6d3b\u6027\u6210\u5206\u6216\u4efb\u4f55\u8f85\u6599\u8fc7\u654f\u3002<\/p>\n
\u5965\u897f\u66ff\u5c3c\u4e0d\u5f97\u4e0e\u5723\u7ea6\u7ff0\u8349\u4e00\u8d77\u670d\u7528(\u89c1[\u836f\u7269\u76f8\u4e92\u4f5c\u7528])\u3002<\/p>\n
<\/p>\n
\u3010\u4e0d\u826f\u53cd\u5e94\u3011<\/p>\n
\u6700\u5e38\u89c1\u4e0d\u826f\u53cd\u5e94(\u226520%)\u4e0d\u826f\u4e8b\u4ef6\u4e3a\u8179\u6cfb(42\uff05)\u3001\u76ae\u75b9(41\uff05)\u3001\u76ae\u80a4\u5e72\u71e5(31\uff05)\u548c\u6307(\u8dbe)\u7532\u6bd2\u6027(25\uff05)\u548c\u75b2\u52b3\u3002<\/p>\n
<\/p>\n
<\/p>\n
\u3010\u8b66\u544a\u548c\u6ce8\u610f\u4e8b\u9879\u3011<\/p>\n
1.\u00a0\u95f4\u8d28\u6027\u80ba\u75c5(ILD)<\/p>\n
\u5728\u4f7f\u7528\u5965\u897f\u66ff\u5c3c\u7684\u60a3\u8005\u66fe\u89c2\u5bdf\u5230\u91cd\u5ea6\u3001\u5371\u53ca\u751f\u547d\u6216\u81f4\u6b7b\u6027\u7684\u95f4\u8d28\u6027\u80ba\u75c5(ILD)\u6216ILD\u6837\u7684\u4e0d\u826f\u53cd\u5e94(\u5982\u975e\u611f\u67d3\u6027\u80ba\u708e)\u3002\u4ed4\u7ec6\u68c0\u67e5\u51fa\u73b0\u80ba\u90e8\u75c7\u72b6(\u547c\u5438\u56f0\u96be\u3001\u54b3\u55fd\u3001\u53d1\u70ed)\u6025\u6027\u53d1\u4f5c\u548c\/\u6216\u4e0d\u660e\u539f\u56e0\u52a0\u91cd\u7684\u60a3\u8005\uff0c\u6392\u9664ILD\u3002\u5728\u5bf9\u8fd9\u4e9b\u75c7\u72b6\u67e5\u627e\u75c5\u56e0\u65f6\uff0c\u5e94\u6682\u505c\u5965\u897f\u66ff\u5c3c\u7684\u7528\u836f\u3002\u5982\u679c\u786e\u8bca\u4e3aILD\uff0c\u5219\u5e94\u505c\u7528\u5965\u897f\u66ff\u5c3c\uff0c\u5e76\u91c7\u53d6\u5fc5\u8981\u7684\u6cbb\u7597\u63aa\u65bd\u3002<\/p>\n
2. QTc\u95f4\u671f\u5ef6\u957f<\/p>\n
\u5728\u670d\u7528\u5965\u897f\u66ff\u5c3c\u7684\u60a3\u8005\u4e2d\u51fa\u73b0\u8fc7QTc\u95f4\u671f\u5ef6\u957f\u3002QTc\u95f4\u671f\u5ef6\u957f\u53ef\u5bfc\u81f4\u5ba4\u6027\u6027\u5fc3\u5f8b\u5931\u5e38(\u5982\u5c16\u7aef\u626d\u8f6c\u578b\u5ba4\u6027\u5fc3\u52a8\u8fc7\u901f)\u6216\u731d\u6b7b\u7684\u98ce\u9669\u589e\u52a0\u3002\u5982\u679c\u53ef\u80fd\uff0c\u60a3\u6709\u5148\u5929\u6027\u957fQT\u95f4\u671f\u7efc\u5408\u5f81\u7684\u60a3\u8005\u5e94\u907f\u514d\u4f7f\u7528\u5965\u897f\u66ff\u5c3c\u3002\u60a3\u6709\u5145\u8840\u6027\u5fc3\u529b\u8870\u7aed\u3001\u7535\u89e3\u8d28\u5f02\u5e38\u6216\u4f7f\u7528\u5df2\u77e5\u80fd\u591f\u5ef6\u957fQTc\u95f4\u671f\u7684\u836f\u7269\u7684\u60a3\u8005\u5e94\u5b9a\u671f\u63a5\u53d7\u5fc3\u7535\u56fe(ECG)\u548c\u7535\u89e3\u8d28\u7684\u76d1\u6d4b\u3002\u81f3\u5c11\u4e24\u6b21\u72ec\u7acb\u5fc3\u7535\u56fe\u68c0\u6d4b\u63d0\u793aQTc\u95f4\u671f>500ms\u7684\u60a3\u8005\u5e94\u6682\u65f6\u505c\u7528\u5965\u897f\u66ff\u5c3c\uff0c\u76f4\u81f3QTc\u95f4\u671f<\/p>\n
<\/p>\n
3.\u00a0\u5fc3\u808c\u6536\u7f29\u529b\u6539\u53d8
\n\u5bf9\u4e8e\u6709\u5df2\u77e5\u5fc3\u8840\u7ba1\u98ce\u9669\u53ca\u5b58\u5728\u53ef\u80fd\u5f71\u54cdLVEF\u60c5\u51b5\u7684\u60a3\u8005\uff0c\u9700\u8981\u8003\u8651\u76d1\u6d4b\u5fc3\u810f\u529f\u80fd\uff0c\u5305\u62ec\u5728\u57fa\u7ebf\u548c\u670d\u836f\u671f\u95f4\u6d4b\u5b9aLVEF\u529f\u80fd\u3002\u5bf9\u4e8e\u5965\u897f\u66ff\u5c3c\u6cbb\u7597\u671f\u95f4\u51fa\u73b0\u5fc3\u810f\u4e8b\u4ef6\u76f8\u5173\u75c7\u72b6\u548c\u4f53\u5f81\u7684\u60a3\u8005\uff0c\u9700\u8981\u8003\u8651\u5fc3\u810f\u76d1\u6d4b\u5305\u62ecLVEF\u529f\u80fd\u6d4b\u5b9a\u3002<\/p>\n
<\/p>\n
4.\u00a0\u5bf9\u9a7e\u9a76\u53ca\u64cd\u7eb5\u673a\u5668\u80fd\u529b\u7684\u5f71\u54cd
\n\u5965\u897f\u66ff\u5c3c\u5bf9\u9a7e\u9a76\u548c\u64cd\u4f5c\u673a\u5668\u80fd\u529b\u65e0\u5f71\u54cd\u6216\u5f71\u54cd\u8f7b\u5fae\u3002<\/p>\n
<\/p>\n
\u3010\u5965\u897f\u66ff\u5c3c\u5b55\u5987\u53ca\u54fa\u4e73\u671f\u5987\u5973\u7528\u836f\u3011<\/p>\n
\u7537\u5973\u6027\u907f\u5b55<\/p>\n
\u80b2\u9f84\u671f\u5973\u6027\u670d\u7528\u5965\u897f\u66ff\u5c3c\u671f\u95f4\u5e94\u907f\u514d\u598a\u5a20\u3002\u6b64\u7c7b\u60a3\u8005\u5728\u5b8c\u6210\u5965\u897f\u66ff\u5c3c\u6cbb\u7597\u540e\u7684\u4e0b\u5217\u65f6\u95f4\u5185\u4ecd\u5e94\u4f7f\u7528\u6709\u6548\u7684\u907f\u5b55\u63aa\u65bd\uff1a\u5973\u6027\u81f3\u5c112\u6708\uff0c\u7537\u6027\u81f3\u5c114\u4e2a\u6708\u3002\u5408\u5e76\u670d\u7528\u5965\u897f\u66ff\u5c3c\u540e\uff0c\u4e0d\u80fd\u6392\u9664\u6fc0\u7d20\u7c7b\u907f\u5b55\u836f\u66b4\u9732\u91cf\u4e0b\u964d\u7684\u98ce\u9669\u3002<\/p>\n
\u598a\u5a20<\/p>\n
\u76ee\u524d\u8fd8\u6ca1\u6709\u598a\u5a20\u5973\u6027\u4f7f\u7528\u5965\u897f\u66ff\u5c3c\u7684\u6570\u636e\uff0c\u6216\u6570\u636e\u975e\u5e38\u6709\u9650\u3002\u52a8\u7269\u7814\u7a76\u63d0\u793a\u5965\u897f\u66ff\u5c3c\u5177\u6709\u751f\u6b96\u6bd2\u6027\uff08\u81f4\u80da\u80ce\u6b7b\u4ea1\u3001\u80da\u80ce\u751f\u957f\u8fdf\u7f13\u3001\u65b0\u751f\u80ce\u4ed4\u6b7b\u4ea1\uff09\u3002\u6839\u636e\u4f5c\u7528\u673a\u5236\u53ca\u4e34\u5e8a\u524d\u6570\u636e\uff0c\u598a\u5a20\u5973\u6027\u4f7f\u7528\u5965\u897f\u66ff\u5c3c\u65f6\u53ef\u80fd\u5bf9\u80ce\u513f\u9020\u6210\u5371\u5bb3\u3002\u9664\u975e\u60a3\u8005\u7684\u4e34\u5e8a\u60c5\u51b5\u9700\u8981\u91c7\u7528\u5965\u897f\u66ff\u5c3c\u6cbb\u7597\uff0c\u5426\u5219\u598a\u5a20\u671f\u95f4\u4e0d\u5f97\u4f7f\u7528\u5965\u897f\u66ff\u5c3c\u3002<\/p>\n
\u54fa\u4e73<\/p>\n
\u76ee\u524d\u5c1a\u4e0d\u660e\u786e\u5965\u897f\u66ff\u5c3c\u6216\u5176\u4ee3\u8c22\u4ea7\u7269\u662f\u5426\u4f1a\u901a\u8fc7\u4eba\u7684\u4e73\u6c41\u6392\u6cc4\u3002\u6b64\u5916\uff0c\u76ee\u524d\u4e5f\u6ca1\u6709\u5145\u5206\u7684\u4fe1\u606f\u8868\u660e\u5965\u897f\u66ff\u5c3c\u6216\u5176\u4ee3\u8c22\u4ea7\u7269\u4f1a\u7ecf\u52a8\u7269\u7684\u4e73\u6c41\u6392\u6cc4\u3002\u7136\u800c\uff0c\u53d7\u4e73\u7684\u80ce\u4ed4\u4f53\u5185\u68c0\u51fa\u4e86\u5965\u897f\u66ff\u5c3c\u53ca\u5176\u4ee3\u8c22\u4ea7\u7269\uff0c\u800c\u4e14\u5bf9\u80ce\u4ed4\u7684\u751f\u957f\u548c\u5b58\u6d3b\u4e5f\u4ea7\u751f\u4e86\u4e0d\u826f\u5f71\u54cd\u3002\u56e0\u6b64\u65e0\u6cd5\u6392\u9664\u5965\u897f\u66ff\u5c3c\u5bf9\u53d7\u4e73\u7684\u5a74\u513f\u4f1a\u4ea7\u751f\u5f71\u54cd\u3002\u56e0\u6b64\uff0c\u91c7\u7528\u5965\u897f\u66ff\u5c3c\u6cbb\u7597\u671f\u95f4\u5e94\u505c\u6b62\u54fa\u4e73\u3002<\/p>\n
\u751f\u80b2\u80fd\u529b<\/p>\n
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