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ID:21652190
大小:276.00 KB
页数:52页
时间:2018-10-19
《肺癌的生物靶向治疗进展》由会员上传分享,免费在线阅读,更多相关内容在教育资源-天天文库。
1、肺癌的生物靶向治疗进展上海市肺科医院肿瘤科CurrentAnti-CancerApproachesSurgeryChemo-therapyRadiationHormonaltherapyTargetedtherapyRemoveknowntumormassesKillrapidlydividingtumorcells,includingtumorcellsinadjacenttissuesKillrapidlydividingtumorcellsInhibitthegrowthandsurvivalofhormone-dependentt
2、umorcellsSpecificallyinhibitprocessesrequiredfortumorcellgrowthWhydoweneednewanticanceragents?*1-yearsurvivalrateDatafromtheEUROCAREIIstudy80706050403020100Relative5-yearsurvivalrate(%)BreastColonKidneyLiverLung*OvaryPancreas1978–19801984–19861987–1989Whatmakesanidealthe
3、rapeutictarget?PresentinthemajorityofpatientswithspecifictumortypeCausativelinkwithtumourigenesisEssentialfunctionintumorcellsAssessingnoveltargetedagentsTypicalcytotoxicMTDOBDToxicityAntitumoureffectEffectTargetDoseOBD>MTDAdaptedfromRowinsky2000TargetToxicityAntitumoureff
4、ectOBDMTDEffectOBD5、altherapyresistancepooroutcomeEGFRhighlyexpressedinNSCLCExtensiveclinicalexperiencewithgefitinibMonotherapyIDEAL1IDEAL25PhaseItrialsCombinationtherapyINTACT1INTACT2ExpandedAccessProgrammePost-marketinguseinJapanOthersalesOtherNSCLCstudiesTrialsinothertumourtypesn20921627076、20684~39,200~39,100~9100~6002600TOTAL~92,750Dataasof3Sept2003IDEAL,IRESSADoseEvaluationinAdvancedLungcancerINTACT,IRESSANSCLCTrialAssessingCombinationTreatmentRandomisationGefitinib250mgoncedailyGefitinib500mgoncedailyPatientsAdvancedNSCLChavingreceived1or2(IDEAL1)or>2(I7、DEAL2)previouschemotherapyregimensContinuegefitinibuntildiseaseprogressionorunacceptabletoxicityPrimaryendpointsResponserate(bothtrials)Safetyprofile(IDEAL1)Symptomrelief(IDEAL2)IDEAL1:platinum,1or2priorregimens(n=209)IDEAL2:platinumanddocetaxel,>2priorregimens(n=216)G8、efitinibPhaseIIstudies:IDEAL1&2Tumourresponse:IDEAL1&2(250mg/day)Objectiveresponserate=
5、altherapyresistancepooroutcomeEGFRhighlyexpressedinNSCLCExtensiveclinicalexperiencewithgefitinibMonotherapyIDEAL1IDEAL25PhaseItrialsCombinationtherapyINTACT1INTACT2ExpandedAccessProgrammePost-marketinguseinJapanOthersalesOtherNSCLCstudiesTrialsinothertumourtypesn2092162707
6、20684~39,200~39,100~9100~6002600TOTAL~92,750Dataasof3Sept2003IDEAL,IRESSADoseEvaluationinAdvancedLungcancerINTACT,IRESSANSCLCTrialAssessingCombinationTreatmentRandomisationGefitinib250mgoncedailyGefitinib500mgoncedailyPatientsAdvancedNSCLChavingreceived1or2(IDEAL1)or>2(I
7、DEAL2)previouschemotherapyregimensContinuegefitinibuntildiseaseprogressionorunacceptabletoxicityPrimaryendpointsResponserate(bothtrials)Safetyprofile(IDEAL1)Symptomrelief(IDEAL2)IDEAL1:platinum,1or2priorregimens(n=209)IDEAL2:platinumanddocetaxel,>2priorregimens(n=216)G
8、efitinibPhaseIIstudies:IDEAL1&2Tumourresponse:IDEAL1&2(250mg/day)Objectiveresponserate=
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