本帖最后由 kangaizhixin 于 2013-4-16 23:58 编辑
esmeralda 发表于 2013-4-16 17:07 static/image/common/back.gif
非常感谢kangaizhixin提供的攻略。
攻略中提到化疗过程可以结合靶向，这样有助于降低或减缓复发和转移，那 ...
HIV治疗就是采用鸡尾酒的方案。在文中谈到“个性化治疗”的理念。只要是针对特定个体的癌基因遗传背景的合理配方组合应该都是可以考虑的治疗方案。联合治疗的主旨也是如此：一人一案，组合可以变化，但是原则是已定的。甚至可以超前考虑。名医的高明在于不仅能治已病，还能治未病。在用药时加上防止癌转移的药物都是可以做为一个考量的策略。因为既然知道肺癌肯定会转移，为什么要等到转移已出现和恶化后再来亡羊补牢呢？只要病人条件许可，当然可以结合化疗。
kangaizhixin 发表于 2013-4-16 22:38 static/image/common/back.gif
Avastin是人性化的单克隆抗体，主要是针对VEGF-A的生物靶药，尽管也是注射给药。现在有在做临床治疗小细胞 ...
感谢楼主的奉献，给我们指明了肺癌治疗的方向。
sequen 发表于 2013-4-16 17:26 static/image/common/back.gif
这里面的药，有相关的试验报道能帖一下吗？谢谢！
等我整理一下再答复你这个问题。
写得非常的详细，一定要让更多的人看到，衷心感谢~~{:soso_e179:}
本帖最后由 kangaizhixin 于 2013-4-22 12:48 编辑
现将目前正在进行临床试验用化疗或放疗结合使用下面药物来治疗小细胞肺癌的靶向和其他药物例举一些供参考：
BAY1000394 (CDKi)
http://my.clevelandclinic.org/cancer/clinical-trials-research/view-cancer-clinical-trial.aspx?TrialID=564
View Cancer Clinical Trials
BAY 1512 | 12-1139
Phase Ib / II study of BAY 1000394 in combination with cisplatin / etoposide or carboplatin/etoposide as first-line therapy in subjects with extensive disease small cell lung cancer
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Disease(s)
Lung
Hospital(s)
Main Campus
Phase(s)
Phase 1
Phase 2
Stage(s)
Type(s)
Therapeutic
Drug(s)
BAY 1000394
Carboplatin
Cisplatin
Etoposide
--------------------------------------------------------------------------------
Contact Information
Cancer Answer Line
866.223.8100
8:00 am - 4:30 pm, Monday - Friday
--------------------------------------------------------------------------------
Description
1.Phase Ib part of the study i.Primary: Determine the safety, tolerability, pharmacokinetics, and maximum tolerated dose of BAY 1000394 in combination with cisplatin / etoposide or carboplatin / etoposide chemotherapy in 2 separate cohorts in parallel
ii.Secondary: Assess the biomarker response profile of BAY 1000394, overall survival, progression-free survival, response rate, duration of response, stable disease and disease control rate
2.Phase II part of the study i.Primary: Evaluate the response rate in subjects with extensive disease SCLC receiving first-line cisplatin / etoposide or carboplatin / etoposide chemotherapy in combination with BAY 1000394. Tumor response will be evaluated based on RECIST 1.1. Tumor measurements will be made at baseline and then every 2 cycles, ie every 6 weeks based on 21-day cycles, until progressive disease will occur
ii.Secondary: Determine the tolerability, safety profile, biomarker response profile, overall survival, progression-free survival, duration of response, and stable disease and disease control rate for the combination of BAY 1000394 and chemotherapy and subsequent maintenance with BAY 1000394
LY2940680 (Hh gene inhibitor)
LY2510924 (CXCR4 inhibitor)
Avastin (anti-angiogenesis)
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Study Record Detail
Study of Oral Topotecan With Bevacizumab for Recurrent Small Cell Lung Cancer
This study has been completed.
Sponsor:
GlaxoSmithKline
Information provided by (Responsible Party):
GlaxoSmithKline
ClinicalTrials.gov Identifier:
NCT00698516
First received: June 16, 2008
Last updated: March 22, 2012
Last verified: March 2011
History of Changes
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Purpose
Combination of Hycamtin (topotecan) and Avastin (bevacizumab) could allow killing of both endothelial and neoplastic cells. We postulate that addition of bevacizumab to topotecan will increase delivery of topotecan to tumor cells and may enhance activity of topotecan in patients with previously treated small cell lung cancer and improve progression free survival.
Condition
Intervention
Phase
Recurrent Small-cell Lung Cancer (SCLC)
Lung Cancer, Small Cell
Drug: Oral Hycamtin (topotecan) Capsules + IV Avastin (bevacizumab)
Phase 2
Study Type:
Interventional
Study Design:
Allocation: Non-Randomized
Endpoint Classification: Safety/Efficacy Study
Intervention Model: Single Group Assignment
Masking: Open Label
Primary Purpose: Treatment
Official Title:
An Open-label, Multicenter, Non-comparative, Phase II Study of Oral Topotecan in Combination With Bevacizumab for Second-line Treatment in Subjects With Relapsed Small-cell Lung Cancer (SCLC)
Resource links provided by NLM:
MedlinePlus related topics: CancerLung Cancer
Drug Information available for: Topotecan hydrochlorideTopotecanBevacizumab
U.S. FDA Resources
Further study details as provided by GlaxoSmithKline:
Primary Outcome Measures: •Percentage of Participants With Progression-free Survival (PFS) at 3 Months [ Time Frame: 3 months ] [ Designated as safety issue: No ]
PFS = time from initiation of drug to time of first disease progression/death due to any cause. Progression assessed using Response Evaluation Criteria (RECIST): >=20% increase in sum of longest diameter (LD) of target lesions, taking as reference the smallest sum LD recorded since treatment started, or appearance of new lesion(s). If participant did not progress or die, the time of initiation of post-treatment anti-cancer therapy or time of last contact used. PFS at 3 months calculated by taking the Kaplan-Meier (KM) estimate at 90 days from the initiation of treatment. SE = standard error.
OSI906 (IGF-1R inhibitor)
另外还有：
Pazopanib
Cabozantinib
Sorafenib
Arsenic Trioxide (砒霜）
谢谢！期待楼主继续。要是中文就更好了。
本帖最后由 kangaizhixin 于 2013-4-17 15:52 编辑
sequen 发表于 2013-4-17 14:14 static/image/common/back.gif
谢谢！期待楼主继续。要是中文就更好了。
例举的两个案例都是联合治疗小细胞癌的：一个用BAY1000394+铂类或依托泊苷; 另一个是Avastin+托普替康。如果经济条件受限，可考虑在医生指导下用砒霜加其他药物联合试试。
本帖最后由 sequen 于 2013-4-17 19:28 编辑
kangaizhixin 发表于 2013-4-17 15:20 static/image/common/back.gif
例举的两个案例都是联合治疗小细胞癌的：一个用BAY1000394+铂类或依托泊苷; 另一个是Avastin+托普替康。 ...
谢谢！好像没讲具体效果如何啊
现在还用不着，还在一线，在为以后多了解一些知识。
谢谢！