我父亲肺鳞癌的治疗贴(2014年3月1日驾鹤西去）

英雄武松 发表于 2012-8-10 01:27

                               
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请问，比如我妈妈，吃易当时也挺好，有效8个月吧，属于EGFR突变型的，那么是不是拉帕替尼的有效可能性就不 ...

是的，老马说的对。
不过，有研究表明，肿瘤发生，有上百种基因发生突变、扩增、抑制等改变。肿瘤发展过程中、治疗过程中基因也在不断发生变异，以适应新的环境变化。所以现在有大牛认为肿瘤是一种自成体系的新的生物种类。
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所以，还是归结为一句说过无数次的老话：试了才知道有效没效。推测仅仅是推测。

我今天观察老爸，发现眉毛和胡子变黑了，新长的头发也是黑的。太奇怪了！@

老马 发表于 2012-8-10 20:16

                               
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3 s, D, Z  `. P( E9 g9 e我今天观察老爸，发现眉毛和胡子变黑了，新长的头发也是黑的。太奇怪了！@

返老还童！

可以实现理想了：看到孙子高中毕业。

另外提示大家：BIBW 2992与食物同时服用会影响吸收，它溶解于pH1~6.8，因此不建议用肠溶胶囊。

另外上上周有病友推荐阿托伐他汀（Liptor，立普妥）代替辛伐他汀，我调查，立普妥的降血脂效果比辛伐他汀要强，但副作用大一倍。

越来越年轻，是不是你给吃什么激素类的吃多了？
; v# X$ r, ]* w% ?! `年轻好啊。

老马 发表于 2012-8-10 20:16

                               
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我今天观察老爸，发现眉毛和胡子变黑了，新长的头发也是黑的。太奇怪了！@

# ]) |4 h1 H% r1 x不奇怪，我家老歌也是这样的.

有个问题：对于her2扩增的，拉帕替尼和阿法替尼效果都不错，拉帕的NSCLC二期临床有一例肿瘤缩小了51%，但对于her2突变的，拉帕效果不成，而阿法替尼有效果。

Lapatinib minimally effective for non-small-cell lung cancer
& u/ S1 S: A) UMARCH 18, 2010
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NEW YORK (Reuters Health) - Although well tolerated, lapatinib is minimally effective as monotherapy for advanced or metastatic non-small-cell lung cancer (NSCLC), according to a report in the March 15th Clinical Cancer Research.
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$ ^5 I/ T7 \1 @+ j. a4 u1 G& E# e0 h, nLapatinib (GlaxoSmithKline) is a tyrosine kinase inhibitor of both epidermal growth factor receptor (EGFR) and HER2, the authors explain, and thus has theoretical advantages over inhibition of either EGFR or HER2 alone.
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! J. y% R* v# c- a0 VDr. Helen J. Ross, from Mayo Clinic, Scottsdale, Arizona, and colleagues evaluated the overall response rate to lapatinib in 131 patients with advanced or metastatic NSCLC. Sixty-five patients were randomized to lapatinib 1500 mg once daily and 66 to lapatinib 500 mg twice daily.
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When the study began, patients with any type of advanced or metastatic NSCLC were recruited ("non-targeted" population). However, when data from other studies began to show that EGFR inhibitors are particularly effective in patients with bronchioloalveolar carcinoma and in never-smokers with any histology of NSCLC, recruitment began to "target" such patients.

' \, u% s( D+ p) QThe targeted population included 24 patients in the 1500 mg/day group and 32 in the 500 mg twice daily group. The corresponding numbers in the non-targeted population were 41 and 34.
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At the interim analysis of the first 30 targeted patients to reach the initial response evaluation, the response rate was 0% in both treatment groups. In the non-targeted population, one patient in the 1500-mg group achieved a partial response.
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Overall, 31 of 131 patients (24%) had stable disease or better.
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; T3 \9 z* h4 a3 S% `Based on these findings, the study was stopped for reasons of futility, the investigators state.
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' p# m* i2 r: _7 X$ Q+ POverall survival in the targeted population was 15.2 months for the 1500-mg once-daily group and 13.9 months for the 500-mg twice-daily group, and in the nontargeted population, overall survival was 11.4 months for the 1500-mg once-daily group and 8.1 months for the 500-mg twice-daily group.
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/ K; f( M5 Z: z$ h) V8 }9 T: YMedian progression-free survival was 15.6 weeks (1500-mg once-daily) and 8.7 weeks (500-mg twice-daily) in the targeted population and 12.0 weeks (1500-mg once-daily) and 8.6 weeks (500-mg twice-daily) in the nontargeted population.

. ^3 Q5 k, W$ BThe incidence of adverse events considered to be related to study medication was 89% for 1500 mg once daily and 83% for 500 mg twice daily, but only 8% of patients in each group experienced serious adverse events related to study medication.
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: S7 x, ~0 }; P. c5 z3 |" i4 mAmong 92 patients with tumor tissue available, 2 had mutations in EGFR and 1 had mutations in both EGFR and KRAS. None had mutations in HER2.

Of 77 patients with sufficient DNA for gene copy evaluation, 5 (8.8%) had increased EGFR copy number and 2 (3.5%) had increased HER2 gene copy number.
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2 \' e" g* L/ QNone of the patients with EGFR mutations responded to lapatinib, and only 1 patient with HER2 amplification had an unconfirmed decrease of 51% in tumor measurement.
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"Lapatinib as a single agent at the doses studied seems to have minimal single-agent activity, at least as measured by response rates," the authors conclude, "although progression-free survival in the 1500-mg once-daily group was in the range that would be expected with first-line chemotherapy."
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"Patients in this small study had a suggestion of disease stabilization with lapatinib," Dr. Ross said. "It would be of interest to examine it in the adjuvant setting after resection perhaps, after chemoradiotherapy perhaps or after up-front chemotherapy. It is possible that combination with other targeted agents, such as anti-angiogenic agents, might be useful."
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, B# c4 l6 b+ Y; p+ eThe study was sponsored by GlaxoSmithKline.