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Song Z, Jiang D, Yu L, Chen Y, Zhou D, Li Y, Wu D, Zhang L, Miao L, Ma J, Zhu J, Jing H, Zhao R, Steering Committee OBOT, Evidence-Based Pharmacy Professional Committee Of Chinese Pharmaceutical Association Cpa TCPATESG, Chinese Pharmaceutical Association Cpa HPPCO, Chinese Pharmacological Society Cps DOTDMO, Clinical Oncology Csco ECOLOCSO, Chinese Society Of Clinical Oncology Csco ECOLO, China Anti-Cancer Association Caca SOICOO, Chinese Medical Association Cma CSOHO, Cross-Straits Medicine Exchange Association Smea HPPCO. Evidence-based expert consensus on clinical management of safety of Bruton's tyrosine kinase inhibitors (2024). Chin J Cancer Res 2024; 36:240-256. [PMID: 38988488 PMCID: PMC11230885 DOI: 10.21147/j.issn.1000-9604.2024.03.02] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2024] [Accepted: 05/17/2024] [Indexed: 07/12/2024] Open
Abstract
Bruton's tyrosine kinase inhibitors (BTKis) have revolutionized the treatment of B-cell lymphomas. However, safety issues related to the use of BTKis may hinder treatment continuity and further affect clinical efficacy. A comprehensive and systematic expert consensus from a pharmacological perspective is lacking for safety issues associated with BTKi treatment. A multidisciplinary consensus working group was established, comprising 35 members from the fields of hematology, cardiovascular disease, cardio-oncology, clinical pharmacy, and evidence-based medicine. This evidence-based expert consensus was formulated using an evidence-based approach and the Delphi method. The Joanna Briggs Institute Critical Appraisal (JBI) tool and Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach were used to rate the quality of evidence and grade the strength of recommendations, respectively. This consensus provides practical recommendations for BTKis medication based on nine aspects within three domains, including the management of common adverse drug events such as bleeding, cardiovascular events, and hematological toxicity, as well as the management of drug-drug interactions and guidance for special populations. This multidisciplinary expert consensus could contribute to promoting a multi-dimensional, comprehensive and standardized management of BTKis.
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Affiliation(s)
- Zaiwei Song
- Department of Pharmacy, Peking University Third Hospital, Beijing 100191, China
- Institute for Drug Evaluation, Peking University Health Science Center, Beijing 100191, China
- Therapeutic Drug Monitoring and Clinical Toxicology Center, Peking University, Beijing 100191, China
| | - Dan Jiang
- Department of Pharmacy, Peking University Third Hospital, Beijing 100191, China
- Institute for Drug Evaluation, Peking University Health Science Center, Beijing 100191, China
- Therapeutic Drug Monitoring and Clinical Toxicology Center, Peking University, Beijing 100191, China
- Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmaceutical Sciences, Peking University, Beijing 100191, China
| | - Lingling Yu
- Department of Pharmacy, Peking University Third Hospital, Beijing 100191, China
- Institute for Drug Evaluation, Peking University Health Science Center, Beijing 100191, China
- Therapeutic Drug Monitoring and Clinical Toxicology Center, Peking University, Beijing 100191, China
| | - Yixuan Chen
- Department of Pharmacy, Peking University Third Hospital, Beijing 100191, China
- Institute for Drug Evaluation, Peking University Health Science Center, Beijing 100191, China
- Therapeutic Drug Monitoring and Clinical Toxicology Center, Peking University, Beijing 100191, China
- Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmaceutical Sciences, Peking University, Beijing 100191, China
| | - Daobin Zhou
- Department of Hematology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100005, China
| | - Yue Li
- Department of Cardiology, the First Affiliated Hospital, Harbin Medical University, Harbin 150001, China
| | - Depei Wu
- Department of Hematology, the First Affiliated Hospital of Soochow University, Suzhou 215006, China
| | - Lingli Zhang
- Department of Pharmacy, Evidence-based Pharmacy Center, West China Second Hospital, Sichuan University, Chengdu 610041, China
| | - Liyan Miao
- Department of Pharmacy, the First Affiliated Hospital of Soochow University, Suzhou 215006, China
| | - Jun Ma
- Department of Hematology and Oncology, Harbin Institute of Hematology and Oncology, Harbin 150010, China
| | - Jun Zhu
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Lymphoma, Peking University Cancer Hospital & Institute, Beijing 100142, China
| | - Hongmei Jing
- Department of Hematology, Peking University Third Hospital, Beijing 100191, China
| | - Rongsheng Zhao
- Department of Pharmacy, Peking University Third Hospital, Beijing 100191, China
- Institute for Drug Evaluation, Peking University Health Science Center, Beijing 100191, China
- Therapeutic Drug Monitoring and Clinical Toxicology Center, Peking University, Beijing 100191, China
| | - On Behalf Of The Steering Committee
- Department of Pharmacy, Peking University Third Hospital, Beijing 100191, China
- Institute for Drug Evaluation, Peking University Health Science Center, Beijing 100191, China
- Therapeutic Drug Monitoring and Clinical Toxicology Center, Peking University, Beijing 100191, China
- Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmaceutical Sciences, Peking University, Beijing 100191, China
- Department of Hematology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100005, China
- Department of Cardiology, the First Affiliated Hospital, Harbin Medical University, Harbin 150001, China
- Department of Hematology, the First Affiliated Hospital of Soochow University, Suzhou 215006, China
- Department of Pharmacy, Evidence-based Pharmacy Center, West China Second Hospital, Sichuan University, Chengdu 610041, China
- Department of Pharmacy, the First Affiliated Hospital of Soochow University, Suzhou 215006, China
- Department of Hematology and Oncology, Harbin Institute of Hematology and Oncology, Harbin 150010, China
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Lymphoma, Peking University Cancer Hospital & Institute, Beijing 100142, China
- Department of Hematology, Peking University Third Hospital, Beijing 100191, China
| | - The Consensus Panel And The Evidence Synthesis Group Evidence-Based Pharmacy Professional Committee Of Chinese Pharmaceutical Association Cpa
- Department of Pharmacy, Peking University Third Hospital, Beijing 100191, China
- Institute for Drug Evaluation, Peking University Health Science Center, Beijing 100191, China
- Therapeutic Drug Monitoring and Clinical Toxicology Center, Peking University, Beijing 100191, China
- Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmaceutical Sciences, Peking University, Beijing 100191, China
- Department of Hematology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100005, China
- Department of Cardiology, the First Affiliated Hospital, Harbin Medical University, Harbin 150001, China
- Department of Hematology, the First Affiliated Hospital of Soochow University, Suzhou 215006, China
- Department of Pharmacy, Evidence-based Pharmacy Center, West China Second Hospital, Sichuan University, Chengdu 610041, China
- Department of Pharmacy, the First Affiliated Hospital of Soochow University, Suzhou 215006, China
- Department of Hematology and Oncology, Harbin Institute of Hematology and Oncology, Harbin 150010, China
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Lymphoma, Peking University Cancer Hospital & Institute, Beijing 100142, China
- Department of Hematology, Peking University Third Hospital, Beijing 100191, China
| | - Hospital Pharmacy Professional Committee Of Chinese Pharmaceutical Association Cpa
- Department of Pharmacy, Peking University Third Hospital, Beijing 100191, China
- Institute for Drug Evaluation, Peking University Health Science Center, Beijing 100191, China
- Therapeutic Drug Monitoring and Clinical Toxicology Center, Peking University, Beijing 100191, China
- Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmaceutical Sciences, Peking University, Beijing 100191, China
- Department of Hematology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100005, China
- Department of Cardiology, the First Affiliated Hospital, Harbin Medical University, Harbin 150001, China
- Department of Hematology, the First Affiliated Hospital of Soochow University, Suzhou 215006, China
- Department of Pharmacy, Evidence-based Pharmacy Center, West China Second Hospital, Sichuan University, Chengdu 610041, China
- Department of Pharmacy, the First Affiliated Hospital of Soochow University, Suzhou 215006, China
- Department of Hematology and Oncology, Harbin Institute of Hematology and Oncology, Harbin 150010, China
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Lymphoma, Peking University Cancer Hospital & Institute, Beijing 100142, China
- Department of Hematology, Peking University Third Hospital, Beijing 100191, China
| | - Division Of Therapeutic Drug Monitoring Of Chinese Pharmacological Society Cps
- Department of Pharmacy, Peking University Third Hospital, Beijing 100191, China
- Institute for Drug Evaluation, Peking University Health Science Center, Beijing 100191, China
- Therapeutic Drug Monitoring and Clinical Toxicology Center, Peking University, Beijing 100191, China
- Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmaceutical Sciences, Peking University, Beijing 100191, China
- Department of Hematology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100005, China
- Department of Cardiology, the First Affiliated Hospital, Harbin Medical University, Harbin 150001, China
- Department of Hematology, the First Affiliated Hospital of Soochow University, Suzhou 215006, China
- Department of Pharmacy, Evidence-based Pharmacy Center, West China Second Hospital, Sichuan University, Chengdu 610041, China
- Department of Pharmacy, the First Affiliated Hospital of Soochow University, Suzhou 215006, China
- Department of Hematology and Oncology, Harbin Institute of Hematology and Oncology, Harbin 150010, China
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Lymphoma, Peking University Cancer Hospital & Institute, Beijing 100142, China
- Department of Hematology, Peking University Third Hospital, Beijing 100191, China
| | - Expert Committee On Lymphoma Of Chinese Society Of Clinical Oncology Csco
- Department of Pharmacy, Peking University Third Hospital, Beijing 100191, China
- Institute for Drug Evaluation, Peking University Health Science Center, Beijing 100191, China
- Therapeutic Drug Monitoring and Clinical Toxicology Center, Peking University, Beijing 100191, China
- Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmaceutical Sciences, Peking University, Beijing 100191, China
- Department of Hematology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100005, China
- Department of Cardiology, the First Affiliated Hospital, Harbin Medical University, Harbin 150001, China
- Department of Hematology, the First Affiliated Hospital of Soochow University, Suzhou 215006, China
- Department of Pharmacy, Evidence-based Pharmacy Center, West China Second Hospital, Sichuan University, Chengdu 610041, China
- Department of Pharmacy, the First Affiliated Hospital of Soochow University, Suzhou 215006, China
- Department of Hematology and Oncology, Harbin Institute of Hematology and Oncology, Harbin 150010, China
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Lymphoma, Peking University Cancer Hospital & Institute, Beijing 100142, China
- Department of Hematology, Peking University Third Hospital, Beijing 100191, China
| | - Expert Committee On Leukemia Of Chinese Society Of Clinical Oncology Csco
- Department of Pharmacy, Peking University Third Hospital, Beijing 100191, China
- Institute for Drug Evaluation, Peking University Health Science Center, Beijing 100191, China
- Therapeutic Drug Monitoring and Clinical Toxicology Center, Peking University, Beijing 100191, China
- Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmaceutical Sciences, Peking University, Beijing 100191, China
- Department of Hematology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100005, China
- Department of Cardiology, the First Affiliated Hospital, Harbin Medical University, Harbin 150001, China
- Department of Hematology, the First Affiliated Hospital of Soochow University, Suzhou 215006, China
- Department of Pharmacy, Evidence-based Pharmacy Center, West China Second Hospital, Sichuan University, Chengdu 610041, China
- Department of Pharmacy, the First Affiliated Hospital of Soochow University, Suzhou 215006, China
- Department of Hematology and Oncology, Harbin Institute of Hematology and Oncology, Harbin 150010, China
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Lymphoma, Peking University Cancer Hospital & Institute, Beijing 100142, China
- Department of Hematology, Peking University Third Hospital, Beijing 100191, China
| | - Society Of Integrative Cardio-Oncology Of China Anti-Cancer Association Caca
- Department of Pharmacy, Peking University Third Hospital, Beijing 100191, China
- Institute for Drug Evaluation, Peking University Health Science Center, Beijing 100191, China
- Therapeutic Drug Monitoring and Clinical Toxicology Center, Peking University, Beijing 100191, China
- Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmaceutical Sciences, Peking University, Beijing 100191, China
- Department of Hematology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100005, China
- Department of Cardiology, the First Affiliated Hospital, Harbin Medical University, Harbin 150001, China
- Department of Hematology, the First Affiliated Hospital of Soochow University, Suzhou 215006, China
- Department of Pharmacy, Evidence-based Pharmacy Center, West China Second Hospital, Sichuan University, Chengdu 610041, China
- Department of Pharmacy, the First Affiliated Hospital of Soochow University, Suzhou 215006, China
- Department of Hematology and Oncology, Harbin Institute of Hematology and Oncology, Harbin 150010, China
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Lymphoma, Peking University Cancer Hospital & Institute, Beijing 100142, China
- Department of Hematology, Peking University Third Hospital, Beijing 100191, China
| | - Chinese Society Of Hematology Of Chinese Medical Association Cma
- Department of Pharmacy, Peking University Third Hospital, Beijing 100191, China
- Institute for Drug Evaluation, Peking University Health Science Center, Beijing 100191, China
- Therapeutic Drug Monitoring and Clinical Toxicology Center, Peking University, Beijing 100191, China
- Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmaceutical Sciences, Peking University, Beijing 100191, China
- Department of Hematology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100005, China
- Department of Cardiology, the First Affiliated Hospital, Harbin Medical University, Harbin 150001, China
- Department of Hematology, the First Affiliated Hospital of Soochow University, Suzhou 215006, China
- Department of Pharmacy, Evidence-based Pharmacy Center, West China Second Hospital, Sichuan University, Chengdu 610041, China
- Department of Pharmacy, the First Affiliated Hospital of Soochow University, Suzhou 215006, China
- Department of Hematology and Oncology, Harbin Institute of Hematology and Oncology, Harbin 150010, China
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Lymphoma, Peking University Cancer Hospital & Institute, Beijing 100142, China
- Department of Hematology, Peking University Third Hospital, Beijing 100191, China
| | - Hospital Pharmacy Professional Committee Of Cross-Straits Medicine Exchange Association Smea
- Department of Pharmacy, Peking University Third Hospital, Beijing 100191, China
- Institute for Drug Evaluation, Peking University Health Science Center, Beijing 100191, China
- Therapeutic Drug Monitoring and Clinical Toxicology Center, Peking University, Beijing 100191, China
- Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmaceutical Sciences, Peking University, Beijing 100191, China
- Department of Hematology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100005, China
- Department of Cardiology, the First Affiliated Hospital, Harbin Medical University, Harbin 150001, China
- Department of Hematology, the First Affiliated Hospital of Soochow University, Suzhou 215006, China
- Department of Pharmacy, Evidence-based Pharmacy Center, West China Second Hospital, Sichuan University, Chengdu 610041, China
- Department of Pharmacy, the First Affiliated Hospital of Soochow University, Suzhou 215006, China
- Department of Hematology and Oncology, Harbin Institute of Hematology and Oncology, Harbin 150010, China
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Lymphoma, Peking University Cancer Hospital & Institute, Beijing 100142, China
- Department of Hematology, Peking University Third Hospital, Beijing 100191, China
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