资源描述：
《蔡俊明教授晚期非小细胞肺癌表皮生长因子受体.ppt》由会员上传分享，免费在线阅读，更多相关内容在PPT专区-天天文库。
1、NSCLCProgressinthetreatment晚期非小细胞肺癌表皮生长因子受体酪氨酸抑制剂的最佳治疗—易瑞沙与特罗凯的比较蔡俊明台北榮民總醫院胸腔部胸腔腫瘤科陽明大學醫學院內科學系三十年来晚期非小细胞肺癌的治疗成果IIIIIIIIIIIIIIIIIIIIIIIIIIIIIII0123456789101112131415161718192021222324252627282930forpatientsindependentofhistology200920082007199819951990s1970s1950sMST(months)BSCCismonotherapy
2、Pt/VP-16Pt/DocPt/PacPt/GemPt/NVB10.9(GC)v.12.6,HR=0.84JMDBAdeno.Cis/PemNon-squamousPac/Cb/Avastin10.3v.12.3,HR=0.7920.4v.17.6NVB/Cis/Erbitux10.1v.11.3,HR=0.87113.1v.13.6,HR=0.9317.4v.28.2,HR=0.46Gem/Cis/AvastinEGFR-TKIs12.5v.18.1,HR=0.66AllAdeno.13.6v.27.2,HR=0.48Mutations15.6v.29.2,HR=0.4
3、8ex19ChemotherapyTargetedTherapyCMTsai2009TumourcellproliferationPI3KMAPKTumourcellsurvivalAktmTORSTAT3/5Grb-2RasRafMEKATPAnti-EGFRAbsCetuximab,Panitumumab,Matuzumab,h-R3,MDX-447Anti-HER1,HER2,HER4TKIsGefitinib,Erlotinib,BIBW-2992,PKI-166,GW-572016,CI-1033,AEE788RASfarnesyltransferaseinhib
4、itorsMMS214662,R115777,SCH66336RAFinhibitorsSorafenib,L-779450MEKinhibitorsCI-1040,U-0126mTORinhibitorsTemsirolimus,RAD001IIIIIIATPSOSSmallmoleculetyrosinekinaseinhibitors表皮生长因子受体讯息传递的生物标记与抑制剂肺腺癌的表皮生长因子受体突变ResponseRatevs.ClinicalBackgroundClinicalBackgroundvs.EGFRMutationsEGFRmutation(%)RR
5、(%)AsianNon-AsianFemaleMaleNeverEverAdenoNon-AdenoAsianNon-AsianFemaleMaleNeverEverAdenoNon-AdenoMitsudomi,IJCO,2006T854AE884KL747SD761Y敏感性突变Sharma,etal.NatRevCancer2007生长因子受体易瑞沙与特罗凯的敏感性突变抗药性突变10055125288283104102TAX317TAX320JMEIIDEAL1IDEAL229Gefitinib7.66.566.858.611.818.4Gefitinib3510055
6、125288283104102TAX317TAX320JMEIIDEAL1IDEAL22231BSCErlotinib4.76.728538.9100551252882831041025631126243488TAX317TAX320JMEIIDEAL1IDEAL2ISELBR212127BSCGefitinib5.15.632488HR=0.89P=0.0870.70<0.001~27~60~10~4042810055125288283TAX317TAX320JMEI1930293230BSCDocetaxelDocetaxelPemetrexed4.67.975.78.
7、31-yrSurvival(%)MS(m)DCR(%)0481201020304047.363.446.653.154.1015304560759.18.86.75.8Docetaxel~70~80~14~47117~60~27~10~40428非小细胞肺癌的救援性治疗ComparisonofDocetaxel,Pemetrexed&EGFR-TKIsGefitinibBR.21versusISEL以安慰剂为对照组的研究FavoursEGFRTKIFavoursplaceboHR0.400.600.801.001.
