厄达替尼的用法用量

Erdafitinib is an oral targeted drug targeting FGFR gene mutations and is mainly used to treat locally advanced or metastatic urothelial carcinoma. This drug exerts anti-tumor effects by precisely inhibiting the FGFR signaling pathway, but it needs to strictly follow medication specifications. This article will introduce in detail the standard usage and dosage of erdafitinib, common side effects and medication precautions for special groups, and provide certain medication reference for patients.

Usage and dosage of erdafitinib

The medication regimen of erdafitinib needs to be formulated based on the genetic test results and the patient’s individual situation. Standardized medication methods are crucial to the therapeutic effect.

Patient Selection Criteria

Prior to use, the presence of FGFR3 gene mutations in the tumor must be confirmed through an FDA-approved companion diagnostic test. It is only applicable to adult patients with locally advanced or metastatic urothelial cancer who have progressed after platinum-based chemotherapy. It is not recommended for those with negative genetic test results.

Standard dosage regimen

The starting dose is 8mg (2 tablets of 4mg) once a day. The whole tablet should be swallowed without being affected by eating. Assess the serum phosphate level after 14-21 days of treatment. If it is lower than 9.0 mg/dL and there are no serious adverse reactions, it can be increased to 9 mg (3 tablets of 3 mg) once a day and continued until disease progression or intolerable toxicity occurs.

Principles for dose adjustment

If vomiting occurs, there is no need to take additional doses, and the medication will be continued as originally planned the next day. Missed doses should be taken as soon as possible, but double dose compensation is not allowed. Depending on the severity of adverse reactions, the medication may need to be suspended or the dose reduced. Specific adjustments must be made in accordance with the doctor's advice.

Regular monitoring of serum phosphate levels and eye conditions is an important basis for dose adjustment, and patients should strictly follow the review plan.

Side effects of erdafitinib

Erdafitinib may cause multi-system adverse reactions, and timely identification and treatment are very important to ensure the continuity of treatment.

Common adverse reactions

Hyperphosphatemia has the highest incidence rate, and dietary phosphate intake needs to be regularly monitored and controlled. Ocular pathologies including dry eye and retinopathy require prophylactic use of artificial tears in all patients. Nail changes, stomatitis, and dry skin are also common and can be relieved with symptomatic care.

Serious adverse reactions

Central serous retinopathy can cause permanent visual impairment, and the drug needs to be discontinued immediately. Soft tissue mineralization may cause complications such as vascular calcification, and blood phosphorus levels need to be strictly controlled. Abnormal liver function requires regular monitoring and dose adjustment if necessary.

Most adverse reactions can be controlled through early intervention, and patients should not stop taking medication due to minor side effects.

Usage of erdafitinib in special groups

Different groups of people have different metabolism and tolerance of the drug, and individualized medication plans are required.

Pregnant and lactating women

Contraindicated in pregnant women. The drug has clear embryotoxicity. Lactating women should suspend breastfeeding during treatment as the drug may be excreted through breast milk. Patients of childbearing age need to take reliable contraceptive measures until 1 month after stopping the drug.

Elderly patients and patients with abnormal liver function

Elderly patients do not need to adjust the starting dose, but need to strengthen monitoring. People with moderate to severe liver function impairment should use reduced dosage. Patients with poor metabolism of CYP2C9 may have elevated plasma drug concentrations and need to be closely observed for adverse reactions.

Pediatric patients

The safety and effectiveness have not been established for patients under 18 years old and its use is not recommended. Special cases should be used with caution after a specialist evaluates the risk-benefit ratio.

The severity of the disease and potential risks must be comprehensively considered when using medication for special groups, and individualized plans must be formulated under the guidance of professional doctors.