Page 140 - 《中国药房》2026年10期

抗体偶联药物治疗乳腺癌后致肺炎和间质性肺病的网状Meta分析
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王晓函 1， 2＊ ，陈 威 ，杨 芳 ，曹可鸣 ，王靖欣 ，薛文鑫 （1.华北理工大学药学院，唐山 063210；2.应急总医
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院药学部，北京 100028；3.应急总医院东院区综合门诊，北京 100016）
中图分类号 R737.9；R969.3 文献标志码 A 文章编号 1001-0408（2026）10-1370-06
DOI 10.6039/j.issn.1001-0408.2026.10.23

摘 要 目的 比较不同抗体偶联药物（ADC）治疗乳腺癌后致肺炎和间质性肺病（ILD）的发生风险。方法 检索中国知网、维普
网、PubMed、Embase等中英文数据库和ClinicalTrials.gov，收集ADC[恩美曲妥珠单抗（T-DM1）、德曲妥珠单抗（T-DXd）、戈沙妥珠
单抗（SG）、德达博妥单抗（Dato-DXd）、瑞康曲妥珠单抗（SHR-A1811）、ARX788、T-Duo]治疗乳腺癌后发生肺炎和ILD的随机对照
试验（RCT），检索时间为建库至 2025 年 6 月 15 日。筛选文献、提取数据、评价文献质量后，采用 Stata 17.0 软件进行网状 Meta 分
析，并对各干预措施的累积排序曲线下面积（SUCRA）进行排序。结果 共纳入 19 项 RCT，共计 10 556 例患者。ARX788、T-DXd
的总体肺炎发生率显著高于 T-DM1、T-DM1 plus TPC（T-DM1 联合帕妥珠单抗或阿替利珠单抗）、TPC（常规治疗）和 SG（P＜
0.05），ARX788、T-DXd的1～2级肺炎发生率显著高于T-DM1、T-DM1 plus TPC和TPC（P＜0.05），上述2个指标SUCRA排序前2
位的均为 ARX788、T-Duo。T-DXd、T-DM1 的≥3 级肺炎发生率显著高于 SG（P＜0.05），SUCRA 排序前 2 位的为 T-Duo、Dato-
DXd。ARX788的总体ILD发生率显著高于T-DM1、SHR-A1811、TPC和SG（P＜0.05），1～2级ILD发生率显著高于T-DM1、SHR-
A1811和TPC（P＜0.05），≥3级ILD发生率显著高于TPC（P＜0.05），上述3个指标SUCRA排序前2位的均为ARX788、T-DXd联
合帕妥珠单抗。结论 相比于其他ADC，ARX788和T-Duo治疗乳腺癌后患者的肺炎和ILD发生风险较高。
关键词 乳腺癌；抗体偶联药物；肺炎；间质性肺病；发生风险

Network meta-analysis of pneumonitis and interstitial lung disease associated with antibody-drug
conjugates in the treatment of breast cancer
WANG Xiaohan ，CHEN Wei ，YANG Fang ，CAO Keming ，WANG Jingxin ，XUE Wenxin（1. School of
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Pharmacy， North China University of Science and Technology， Tangshan 063210， China；2. Dept. of Pharmacy，
Emergency General Hospital， Beijing 100028， China；3. Dept. of General Outpatient， East Campus， Emergency
General Hospital， Beijing 100016， China）
ABSTRACT OBJECTIVE To compare the risk of pneumonitis and interstitial lung disease （ILD） associated with different
antibody-drug conjugates （ADC） in the treatment of breast cancer. METHODS CNKI， VIP， PubMed， Embase and other Chinese
and English databases， and ClinicalTrials.gov were searched from the inception to June 15， 2025. Randomized controlled trials
（RCT） about pneumonitis and ILD associated with ADC （T-DM1， T-DXd， SG， Dato-DXd， SHR-A1811，ARX788， and T-Duo） in
the treatment of breast cancer were included. After literature screening， data extraction， and quality assessment， a network meta-
analysis was conducted using Stata 17.0 software， and the surface under the cumulative ranking curve（SUCRA） of all
interventions were ranked. RESULTS A total of 19 RCTs involving 10 556 patients were included. The overall incidence of
pneumonitis with ARX788 and T-DXd was significantly higher than that with T-DM1， T-DM1 plus TPC（T-DM1combined with
pertuzumab or atezolizumab）， TPC（treatment of primary care）， and SG （P＜0.05）， for grade 1-2 pneumonitis， ARX788 and T-
DXd showed significantly higher incidence than T-DM1， T-DM1 plus TPC， and TPC （P＜0.05）. For both indicators， ARX788 and
T-Duo were ranked as the top two by SUCRA. For the incidence of grade ≥3 pneumonitis， T-DXd and T-DM1 were significantly
higher than SG （P＜0.05）， T-Duo and Dato-DXd were ranked as the top two by SUCRA. For overall incidence of ILD， ARX788
was significantly higher than T-DM1， SHR-A1811， TPC， and SG （P＜0.05）， for the incidence of grade 1-2 ILD， ARX788 was
significantly higher than T-DM1， SHR-A1811， and TPC （P＜0.05）， for the incidence of grade ≥3 ILD， ARX788 was
significantly higher than TPC （P＜0.05）. For three indicators above， ARX788 and T-DXd combined with pertuzumab were ranked
as the top two by SUCRA. CONCLUSIONS Compared with
Δ 基金项目 应急总医院医学发展科研基金（No.KY202625）
＊ 第一作者 硕 士 研 究 生 。 研 究 方 向 ：临 床 药 学 。 E-mail： other ADCs， ARX788 and T-Duo are associated with a higher
risk of pneumonitis and ILD in patients with breast cancer.
wpcy1127@163.com
# 通信作者 主任药师，硕士生导师，博士。研究方向：临床药学。 KEYWORDS breast cancer； antibody-drug conjugates；
E-mail：xuewx200866@163.com pneumonitis； interstitial lung disease； risk

· 1370 · China Pharmacy 2026 Vol. 37 No. 10 中国药房 2026年第37卷第10期