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我父亲肺鳞癌的治疗贴(2014年3月1日驾鹤西去)

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1279951 1628 老马 发表于 2011-10-27 08:05:18 | 置顶 |
平安!  退休老干部 发表于 2012-8-10 09:52:18 | 显示全部楼层 来自: 湖南长沙
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是的,老马说的对。) w5 [+ G6 W; A# b5 U
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。/ Q7 n; P9 C2 m  v! i
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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。

点评

谢谢平安大夫的点评。  发表于 2012-8-10 13:25
老马  博士一年级 发表于 2012-8-10 20:16:26 | 显示全部楼层 来自: 浙江杭州
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!@
个人公众号:treeofhope
平安!  退休老干部 发表于 2012-8-10 21:53:10 | 显示全部楼层 来自: 湖南长沙
老马 发表于 2012-8-10 20:16 : `; k+ B( _4 d6 n
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!@

& K0 T9 J, B# w' j8 b+ |; s1 H返老还童!
luyi3113  大学一年级 发表于 2012-8-10 22:07:21 | 显示全部楼层 来自: 江苏苏州
可以实现理想了:看到孙子高中毕业。
老马  博士一年级 发表于 2012-8-11 14:15:19 | 显示全部楼层 来自: 浙江杭州
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。
个人公众号:treeofhope
老马  博士一年级 发表于 2012-8-11 14:29:27 | 显示全部楼层 来自: 浙江杭州
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。
个人公众号:treeofhope
英雄武松  大学四年级 发表于 2012-8-11 19:56:52 | 显示全部楼层 来自: 哈萨克斯坦
越来越年轻,是不是你给吃什么激素类的吃多了?
) k5 x& ^  }- C) M年轻好啊。
慧质兰馨  大学四年级 发表于 2012-8-11 20:20:37 | 显示全部楼层 来自: 江苏南京
老马 发表于 2012-8-10 20:16
1 M" Q# W/ n9 U  u8 A: t3 V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!@

1 H  q0 Z- x& {' D7 }3 D不奇怪,我家老歌也是这样的.
老马  博士一年级 发表于 2012-8-11 23:43:22 | 显示全部楼层 来自: 浙江杭州
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。
个人公众号:treeofhope
老马  博士一年级 发表于 2012-8-12 00:41:52 | 显示全部楼层 来自: 浙江杭州
Lapatinib minimally effective for non-small-cell lung cancer
" f5 ], L( o1 |2 |1 |MARCH 18, 2010  P' X" |$ W: X! `6 a8 Z  a* c

" b  o" L4 u8 U8 ]. K3 pNEW 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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Lapatinib (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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Dr. 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.$ b* h8 o$ n" s& x- _0 v
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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.
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6 x, G# a4 G4 m; |, hThe 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.: O2 {6 S) E; n# E0 @

7 t/ K0 I5 ?) _  W- pAt 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. % `  q3 I' c: L
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Overall, 31 of 131 patients (24%) had stable disease or better.
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. U. ?2 x/ X; ?Based on these findings, the study was stopped for reasons of futility, the investigators state. 9 `  N$ {! A; _- ?% q" w  {* C6 W
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Overall 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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/ }% ~0 z8 W- F2 `# r6 o4 gMedian 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.
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The 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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Among 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. ; b% D7 e/ G( r
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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. # d- Y5 C) @$ u5 ?

- C9 e% s( u  E7 S4 q0 B  u. z( nNone 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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; A0 X) I9 Q# ^) ~' g( y" Y"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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The study was sponsored by GlaxoSmithKline.. C: y7 R6 A% d1 D0 y% u' o7 c
个人公众号:treeofhope

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