Serious Delayed Diarrhea Induced by IRIS Regimen in an UGT1A1-wild-genotype Patient

doi:10.19803/j.1672-8629.2020.06.12

Abstract

Abstract: Objective To report and analyze one case of serious delayed diarrhea induced by chemotherapy of irinotecan combined with S-1 (IRIS regimen) in an uridine-diphosphoglucuronosyl transferase 1A1 (UGT1A1)-wild-genotype patient with metastatic recal cancer. Methods The diagnosis and treatment process of the case of delayed diarrhea after IRIS regimen chemotherapy was analyzed and related literature was reviewed. Results The serious delayed diarrhea was possibly induced by IRIS regimen chemotherapy, which might be related to the gene polymorphisms of irinotecan transporters and the combination with S-1. Conclusion We should be alert to the occurrence of serious delayed diarrhea when IRIS regimen chemotherapy is used for UGT1A1-wild-genotype patients.

Key words: Delayed diarrhea, IRIS regimen, UGT1A1 gene polymorphisms

CLC Number:

R978.7

MEI Dan, LU Junguo, GU Haijuan, NI Meixin. Serious Delayed Diarrhea Induced by IRIS Regimen in an UGT1A1-wild-genotype Patient[J]. Chinese Journal of Pharmacovigilance, 2020, 17(6): 373-376.

References

[1] Higashi D, Egawa Y, Hirano Y, et al.Efficacy and safety of Irinotecan and Plus S-1(IRIS) therapy to treat advanced/recurrent colorectal cancer[J]. Anticancer Res, 2014, 34(8): 4595-4599.
[2] Muro K, Boku N, Shimada Y, et al.Irinotecan plus S-1 (IRIS) versus fluorouracil and folinic acid plus irinotecan (FOLFIRI) as second-line chemotherapy for metastatic colorectal cancer: a randomised phase 2/3 non-inferiority study (FIRIS study)[J]. Lancet Oncol, 2010, 11(9): 853-860.
[3] Cunningham D, Pyrhonen S, James RD, et al.Randomised trial of irinotecan plus supportive care versus supportive care alone after fluorouracil failure for patients with metastatic colorectal cancer[J]. Lancet, 1998, 352(9138): 1413-1418.
[4] Shirao K, Ohtsu A, Takada H, et al.Phase II study of oral S-1 for treatment of metastatic colorectal carcinoma[J]. Cancer, 2004, 100(11): 2355-2361.
[5] Goto A, Yamada Y, Yasui H, et al.Phase II study of combination therapy with S-1 and irinotecan in patients with advanced colorectal cancer[J]. Ann Oncol, 2006, 17(6): 968-973.
[6] 田述梅. 伊立替康联合替吉奥胶囊作为转移性结直肠癌二线化疗的疗效和不良反应分析[J]. 齐齐哈尔医学院学报, 2011,32(16): 2580-2582.
[7] 任光辉, 赵文河, 于文莉. 替吉奥胶囊单药在大肠癌患者姑息手术后化疗的临床疗效及不良反应研究[J]. 中华肿瘤防治杂志, 2016, 23(S1): 153-154.
[8] 吕建华, 吕建莉, 李永兵. 替吉奥胶囊单药三线治疗老年晚期结直肠癌的疗效分析[J]. 中国药物警戒, 2016,13(5): 263-265.
[9] 梅丹, 陆俊国, 顾海娟, 等. 伊立替康化疗相关性腹泻发生的特点与危险因素分析[J]. 中国医院药学, 2019, 39(2): 191-195.
[10] 王丹. 替吉奥致围抗癌化疗期腹泻的护理[J]. 实用临床护理学杂志, 2016, 1(5): 136-137.
[11] 中国临床肿瘤学会(CSCO)结直肠癌诊疗指南工作组. 中国临床肿瘤学会(CSCO)结直肠癌诊疗指南(2017版)[EB/OL].(2016-12-18) [2019-05-13].http://guide.medlive.cn/guideline/13494.
[12] Naranjo CA, Busto U, Sellers EM, et al.A method for estimatingthe probability of advance drug reactions[J]. Clin Pharmacol Ther, 1981, 30(2): 239-245.
[13] de Man FM, Goey AKL, van Schaik RHN, et al. Individualization of irinotecan treatment: A review of pharmacokinetics, pharm- acodynamics, and pharmacogenetics[J]. Clin Pharmacokinet, 2018, 57(10): 1229-1254.
[14] 张昊, 吴婷婷, 李莹, 等. 地塞米松治疗化疗相关性腹泻1例并文献复习[J]. 肿瘤防治研究, 2018, 45(11): 938-940.
[15] 张晓光, 张侠. 25例伊立替康治疗晚期肠癌致不良反应的分析[J]. 中国药物警戒, 2013, 10(3): 168-171.
[16] Kweekel D, Guchelaar HJ, Gelderblom H.Clinical and pharm- acogenetic factors associated with irinotecan toxicity[J]. CancerTreat Rev, 2008, 34(7): 656-669.
[17] 李慧. 伊立替康不良反应影响因素的建模分析[D]. 山东大学,2014.
[18] Di Martino MT, Arbitrio M, Leone E, et al.Single nucleotide polymorphisms of ABCC5 and ABCG1 transporter genes correlate to irinotecan-associated gastrointestinal toxicity in colorectal cancer patients: a DMET microarray profiling study[J]. Cancer Biol Ther, 2011, 12(9): 780-787.
[19] Lee W, Kim RB.Transporters and renal drug elimination[J].Annu Rev Pharmacol Toxicol, 2004(44): 137-166.