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易瑞沙 耐药后的解决方案,请大家都来找出路

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发表于 2007-6-3 03:25:25 | 显示全部楼层

Remarkable Effect of Gefitinib Retreatment in a Patient with Nonsmall Cell Lung Cancer Who Had a Complete Response to Initial Gefitinib.

Case Reports

American Journal of the Medical Sciences.    333(4):221-225, April 2007.
   Yoshimoto, Akihiro MD;  Inuzuka, Kanako MD;  Kita, Toshiyuki MD;  Kawashima, Atsuhiro MA, MD;  Kasahara, Kazuo MD   


Abstract:
Gefitinib is an orally active epidermal growth factor receptor tyrosine kinase inhibitor, and it shows favorable antitumor activity against chemorefractory nonsmall cell lung cancer (NSCLC). However, patients with NSCLC have few treatment options available if they are refractory to gefitinib. We describe a 49-year-old patient with NSCLC who had a complete response to initial gefitinib that lasted for 12 months. The tumor relapsed, and the patient received cytotoxic chemotherapy. However, despite chemotherapy, the patient had radiographic progression of lung metastases and we commenced retreatment with gefitinib, showing a remarkable effect. Epidermal growth factor receptor (EGFR) gene analysis showed deletion mutations in codon 745-750 in exon 19 and EGFR gene amplification. Our case shows that after retreatment with gefitinib, patients may show a remarkable response if they showed a remarkable response to initial gefitinib administration and if a certain time has elapsed since the previous gefitinib treatment.

(C) Copyright 2007 Southern Society for Clinical Investigation

非小细胞肺癌患者初次用iressa有完全效,抗药后再次用药,效果显著

 报告病例

美国杂志的医学科学. 333 ( 4 ) :221 - 225 , 20074.

作者:yoshimoto ,昭裕医生; inuzuka , kanako 医生 ; 基塔, toshiyuki 医生 ; ,曝露, 医生 ; kasahara ,喀左,医生

摘要:

gefitinib是一种口服活跃表皮生长因子受体酪氨酸激酶抑制剂, 而且对于化疗抗药的非小细胞肺癌病人,显示了良好得疗效 . , 如果细胞肺癌患者对iressa 抗药,们只有很少的治疗方法可选择。 们描述一位49岁的非细胞肺癌病人,他第一次的iressa治疗有完全疗效, 历时12个月. 肿瘤复发,病人接受化. 但是,尽管化,病人已有radiographic progression转移,们开始再次使用iressa, 现出显着的效果. 表皮生长因子受体( EGFR )基因分析发现缺失突变745-750码子19EGFR基因扩增.

 

们的个案显示, 如果患者第一次用iressa有显着的效果,从上次iressa治疗后,

某个 时间已经过去, 再用iressa 之后, 他们仍会出现明显的疗效.

 

 ( c )2007南社临床调查

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发表于 2007-6-3 03:26:25 | 显示全部楼层

A Case of Adenocarcinoma of the Lung with a Favorable Response to Retreatment with Gefitinib

Hideki Shibuya1), Tomoko Kutomi1), Yoko Sato1), Naoki Tashiro1), Kei Hara1) and Tetsuya Hisada1)

1) Department of Respiratory Medicine, Tokyo Teishin Hospital

(Received March 2, 2006)
(Accepted
April 26, 2006)

Abstract  Background. Gefitinib showed response rate of 10-20% in chemorefractory non-small cell lung cancer cases, while even in patients who responded, tumor recurrence Case of Adenocarcinoma of the Lung with a Favorable Response to Retreatment with Gefitinib

Hideki Shibuya1), Tomoko Kutomi1), Yoko Sato1), Naoki Tashiro1), Kei Hara1) and Tetsuya Hisada1)

1) Department of Respiratory Medicine, Tokyo Teishin Hospital

(Received March 2, 2006)
(Accepted
April 26, 2006)

Abstract  Background. Gefitinib showed response rate of 10-20% in chemorefractory non-small cell lung cancer cases, while even in patients who responded, tumor recurrence can appear during the therapy. There are only a few reports about patients successfully retreated with gefitinib. Here we report a case of adenocarcinoma of the lung with a favorable response to retreatment with gefitinib. Case. A 37-year-old woman presented with left chest pain, cough, and dyspnea on exertion in February 2004. Her chest radiograph and CT revealed multiple nodular shadows throughout both lung fields. Adenocarcinoma of the lung was diagnosed (cT1N2M1). Because of progressive disease after two courses of chemotherapy with cisplatin and gemcitabine, she was given gefitinib therapy in May 2004 and a partial response was achieved. However, gefitinib was discontinued after 6 months of treatment, due to regrowth of the tumors. The tumors continued to grow even after further chemotherapy (four courses of cisplatin and docetaxel, followed by three courses of carboplatin and paclitaxel). She was retreated with gefitinib in June 2005, with a partial response once again. Conclusion. Retreatment with gefitinib may yield good results in patients with non-small cell lung cancer who are refractory to chemotherapy.

一个肺腺癌抗药后再用 iressa (gefitinib) 取得良好结果的病例

作者: Hideki Shibuya , tomoko kutomi yoko sato , naoki tashiro , Kei Haratetsuya hisada

东京通信医院呼吸内科医学科, 200632(收到) (2006426日接)

" --摘要—"背景.

对化疗抗药的非小细胞肺癌病人中,10-20%的病人用 iressa 疗是有效的

然而即使是这些病人,仍可以出现在治疗中肿瘤进展(--即抗). 目前只有寥寥可数的关于患者抗药后,再次用药成功的报道. 这里, 们介绍 一例肺腺癌抗药再次用药成功例子。

案例: 一位37岁的女性,左胸部疼痛, 咳嗽及呼吸困难,劳累, 起于20042. 她的胸部X光及电脑断层检查发现多处结节影,遍布整个双肺. 诊断为肺腺癌 ( ct1n2m1 ) .两个疗程后(顺铂和健择) ,由于病情发展, 20045月,她接受IRESSA疗,取得了局部的疗效. 过,6个月的治疗后, 肿瘤开始继续增长, , 中断IRESSA疗。以后再化疗(门疗程铂和紫杉醇, 接着由三个疗程铂与紫杉醇) 肿瘤无法控制,继续增长,她于20056月再次接受IRESSA, 再次取得了局部的疗效.

结论. ,在治疗对化疗抗药的非小细胞肺癌时,iressa (gefitinib)  药后再用,仍可能取得好的效果

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发表于 2007-6-3 04:23:15 | 显示全部楼层

Retreatment of Lung Adenocarcinoma Patients With Gefitinib Who Had Experienced Favorable Results From Their Initial Treatment With This Selective Epidermal Growth Factor Receptor Inhibitor: A Report of Three Cases

Authors: Yano, Seiji1; Nakataki, Emiko1; Ohtsuka, Shinsaku1; Inayama, Mami1; Tomimoto, Hideki1; Edakuni, Nobutaka1; Kakiuchi, Soji1; Nishikubo, Naoki1; Muguruma, Hiroaki1; Sone, Saburo1

Source: Oncology Research Incorporating Anti-Cancer Drug Design, Volume 15, Number 2, 2005, pp. 107-111(5)

Publisher: Cognizant Communication Corporation

Abstract:

Gefitinib is a selective inhibitor of epidermal growth factor receptor (EGFR) tyrosine kinases, and shows favorable antitumor activity against chemorefractory non-small cell lung cancer (NSCLC). The majority of responders (patients who are sensitive to gefitinib), however, relapse within 1.5 years, indicating an acquired resistance to gefitinib. Here we report three chemotherapy refractory NSCLC patients who were retreated with gefitinib. All three cases were nonsmokers and showed an adenocarcinoma histology. While they had experienced successful control from their initial treatment with gefitinib for more than 12 months, gefitinib therapy was terminated because two cases (cases 1 and 3) relapsed during the therapy and case 2 suffered alveolar hemorrhage. After more than 7 months from the time of discontinuation of the initial gefitinib treatment, they were retreated with gefitinib, as further tumor progression was observed. Of the three cases, cases 1 and 2 were well controlled by retreatment with gefitinib monotherapy for more than 7 months, suggesting sensitivity to retreatment. Case 3 also showed a regression in size of several tumors, while some other lesions progressively enlarged and developed a malignant pleural effusion after 4 months. These observations suggest the possibility that retreatment with gefitinib might be useful when 1) initial treatment shows a favorable clinical response, and 2) there has been a period of time following the termination of the initial gefitinib treatment.

Keywords: Retreatment; Acquired resistance; Gefitinib; Lung cancer; Alveolar hemorrhage

Document Type: Research article

Affiliations: 1: Department of Internal Medicine and Molecular Therapeutics, The University of Tokushima Graduate School, 3-18-15 Kuramoto-cho, Tokushima, Japan

肺腺癌患者iressa抗药后再用药的3报告(如果患者最初这种选择性表皮 长因子受体抑制剂经历了较好的疗效)

作者:, seiji1 ; nakataki , emiko1 ; ohtsuka , shinsaku1 ; inayama , mami1 ; tomimoto , hideki1 ; edakuni , nobutaka1 ; kakiuchi , soji1 ; nishikubo , naoki1 ; muguruma , hiroaki1 ; sone , saburo1

来源:肿瘤研究,将抗癌药物的设计 15,2, 2005, pp . 107-111 ( 5 )

出版商: cognizant通信公司

摘要:

gefitinib是一种选择性抑制表皮生长因子受体( EGFR )酪氨酸激酶,

对化疗药的非小细胞肺癌(NSCLC) 具有良好的效果。然而, 大多数iressa反应良好的 病人 , 1.5复发。这 表明iressa抗药了 . 这里我们报告三个化疗难治肺癌病人,

重用iressa的例子. 三人是非吸烟者,并呈现出腺癌组织,. 虽然他们最初的iressa疗,成功的控制病情12个月, iressa疗被终止,

为两例(病例13 ) 在治疗中病情复发了,案例2蒙受肺泡 出血. 从停止了最初的iressa疗,经过超过7个月的时间,们重新使用iressa ,为进一步预后观察. 上述三个案件 1和第2名的用iressa单药治疗,控制超7个月, 提示重新使用iressa是有效的. 案例3显示了几个肿瘤的缩小,但 另一些病变逐渐扩大,4个月,形成了恶性胸水. 这些情况提示了一种可能性,--再用iressa可能是有用的, 如果

1)   步治,显示了良好的临床 ,

2 ) 最初iressa疗抗药停药后. 有一段时期.

 

关键词: retreatment ; 获得抗性; gefitinib ; 肺癌; 肺泡出血文件类型

:研究论文背景:

1 : , 徳島大学研究生院,内科医和分子疗法系, 3-18-15 Kuramoto-cho,徳島市 ,日本

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发表于 2007-6-3 07:35:17 | 显示全部楼层
希望能看到更多的信息,谢谢大家!
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发表于 2007-6-3 11:01:06 | 显示全部楼层

看了这些病例,受到了一些鼓舞,上面这些病例中,从停止到再次使用的时间大概半年左右,我父亲2007年3月26日停IRESSA,经过两个疗程的CO+恩度方案,显示病情没有明显进展,但有部分变化,我们决定从2007年6月3日重新开始服用IRESSA+反应停.

停药大概只有2个月的时间,是不是时间间隔的太少了? 矛盾ing.

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发表于 2007-6-3 12:23:07 | 显示全部楼层
clough:
    还有2篇没翻译,其中一篇讨论了27个病例,
时间间隔0。6-7。8个月,0。6月的无效,但1。9月的是稳定。更长的也是稳定甚至缩小
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发表于 2007-6-3 20:44:00 | 显示全部楼层

  我妈妈正在服用英版易瑞沙,这些天一直关注抗药以后的用药方法。

jimmy112199:谢谢你给大家提供的信息,辛苦了~~

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发表于 2007-6-4 12:43:14 | 显示全部楼层

我母亲吃了快9个月了,也在积极寻找耐药之后的方法

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