蛋白酶体抑制剂（PI）通过肿瘤抑制蛋白和促凋亡蛋白导致细胞死亡，是许多血液恶性肿瘤治疗中不可或缺的组成部分，但因其胃肠道不良反应而受到限制。关于这些 PI 相关不良反应的证据很少。在这项研究中，我们评估了PI引起的胃肠道不良事件，并比较了硼替佐米、卡非佐米和伊沙佐米之间的胃肠道毒性。我们对三级癌症中心接受PI治疗的癌症患者进行了回顾性研究，以调查PI相关的临床特征胃肠道不良事件。我们的样本包括 2017 年 1 月至 2022 年 12 月期间进行过 PI 暴露和粪便研究的 973 名患者。根据临床症状和粪便研究结果，其中 193 名患者 (20%) 患有 PI 相关胃肠道毒性。最常见的症状是腹泻，有 169 人出现（其中 88% 有胃肠道毒性）。 22 人 (11%) 需要住院治疗，71 人 (37%) 出现症状复发。与硼替佐米或卡非佐米相比，伊沙佐米从开始 PI 到出现胃肠道症状的时间间隔更长（313 天 vs 58 天 vs 89 天，p = 0.002），并且以腹泻为主的胃肠道毒性表现百分比显着较低（71%） vs 96% vs 91%, p = 0.048）。虽然PI相关的胃肠道毒性根据不同的治疗方案有不同的表现和病程，但绝大多数患者表现出较轻微的疾病行为。尽管住院率和治疗后复发率相当高，需要优化临床管理，但我们的队列显示出良好的结果，且没有长期后果。© 2024。作者。

Proteasome inhibitors (PIs), which cause cell death via tumor suppressor and pro-apoptotic proteins, are integral to treatment of many hematologic malignancies but are limited by their gastrointestinal adverse effects. Evidence regarding these PI-related adverse effects is scant. In this study, we evaluated gastrointestinal adverse events caused by PIs and compared gastrointestinal toxicities between bortezomib, carfilzomib, and ixazomib.We conducted a retrospective study of cancer patients treated with PIs at a tertiary care cancer center to investigate the clinical characteristics of PI-related gastrointestinal adverse events.Our sample comprised 973 patients with PI exposure and stool studies ordered between January 2017 and December 2022. Of these, 193 patients (20%) had PI-related gastrointestinal toxicity based on clinical symptoms and stool study results. The most common symptom was diarrhea, present in 169 (88% of those with gastrointestinal toxicity). Twenty-two (11%) required hospitalization, and 71 (37%) developed recurrence of symptoms. Compared to bortezomib or carfilzomib, ixazomib had a longer interval from PI initiation to the onset of gastrointestinal symptoms (313 days vs 58 days vs 89 days, p = 0.002) and a significantly lower percentage of diarrhea-predominant presentation of gastrointestinal toxicity (71% vs 96% vs 91%, p = 0.048).While PI-related gastrointestinal toxicities have various presentations and courses based on different regimens, the vast majority of patients presented with milder disease behavior. Despite a considerably high rate of hospitalization and recurrence after treatment necessitating optimization of clinical management, our cohort demonstrates favorable outcomes without long-term consequences.© 2024. The Author(s).