肺癌的生物靶向治疗进展

肺癌的生物靶向治疗进展

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时间:2018-10-19

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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、umorcellsSpecificallyinhibitprocesses requiredfortumorcellgrowthWhydoweneednewanticanceragents?*1-yearsurvivalrateDatafromtheEUROCAREIIstudy80706050403020100Relative5-year survivalrate(%)BreastColonKidneyLiverLung*OvaryPancreas1978–19801984–19861987–1989Whatmakesanidealthe

3、rapeutictarget?PresentinthemajorityofpatientswithspecifictumortypeCausativelinkwithtumourigenesisEssentialfunctionintumorcellsAssessingnoveltargetedagentsTypicalcytotoxicMTDOBDToxicityAntitumoureffectEffectTargetDoseOBD>MTDAdaptedfromRowinsky2000TargetToxicityAntitumoureff

4、ectOBDMTDEffectOBD

5、altherapyresistancepooroutcomeEGFRhighlyexpressedinNSCLCExtensiveclinicalexperiencewithgefitinibMonotherapyIDEAL1IDEAL25PhaseItrialsCombinationtherapyINTACT1INTACT2ExpandedAccessProgrammePost-marketinguseinJapanOthersalesOtherNSCLCstudiesTrialsinothertumourtypesn2092162707

6、20684~39,200~39,100~9100~6002600TOTAL~92,750Dataasof3Sept2003IDEAL,IRESSADoseEvaluationinAdvancedLungcancerINTACT,IRESSANSCLCTrialAssessingCombinationTreatmentRandomisationGefitinib250mgoncedailyGefitinib500mgoncedailyPatientsAdvancedNSCLChavingreceived 1or2(IDEAL1) or>2(I

7、DEAL2) previous chemotherapy regimensContinuegefitinibuntildisease progressionorunacceptabletoxicityPrimaryendpointsResponserate(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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