美国——肺癌一线上靶向药

campion · 发表于 2007-8-19 16:22:17

<div style="FONT-SIZE: 12pt; FONT-FAMILY: times new roman, new york, times, serif;">Question 1.  Should we start with Iressa or Tarceva?  Is Tarceva better than Iressa?  <span class="313542213-11072007"><font face="Arial" color="#0000ff" size="2"> Either is fine. Iressa may have fewer side effects. <font color="#f73809">问:是易瑞莎还是特洛凯比较好？答：两个都不错，但是易瑞莎副作用比较少</font></font></span></div><div style="FONT-SIZE: 12pt; FONT-FAMILY: times new roman, new york, times, serif;"> </div><div style="FONT-SIZE: 12pt; FONT-FAMILY: times new roman, new york, times, serif;">Question 2.  Do EGFR targetted agents (like Iressa and Tarceva) give patients longer life, or just improve the life quality? <span class="313542213-11072007"><font face="Arial" color="#0000ff" size="2"> Longer life and better quality. </font></span>
<font color="#f70909">问：易瑞莎和特洛凯是能延长生存时间还是提高生活质量？答：既能延长生存时间也能提高生存质量</font> I heard that once Iressa/Tarceva resistance happens, the tumor would grow even faster in a crazy way, which means that the overall survival time for a patient is the same, no matter whether he take the EGFR targetting drug or not.  Is this true? <span class="313542213-11072007"><font face="Arial" color="#0000ff" size="2"> No <font face="Times New Roman" color="#f73809" size="3">问：我听说易瑞莎和特洛凯一旦耐药，肿瘤生长速度会更快，意味着他们并不能延长生存时间，这是真的吗？答：不是真的。</font></font></span> Tarceva has shown survival prolongation, but not Iressa, is this true?<span class="313542213-11072007"><font face="Arial" color="#0000ff" size="2">  In unselected Caucasian populations, but not in Asians nor in non-smokers. <font color="#ff0000">问：特洛凯已经证明能够延长生存时间，但是易瑞莎不能，是这样吗？答：在白人里是这样，但是在亚洲人和非吸烟患者里不是这样。</font></font></span></div><div style="FONT-SIZE: 12pt; FONT-FAMILY: times new roman, new york, times, serif;"> </div><div style="FONT-SIZE: 12pt; FONT-FAMILY: times new roman, new york, times, serif;">Question 3.  What would you do to the patient once the drug resistance happens?  What's the standard treatment here in the U.S.?  <span class="313542213-11072007"><font face="Arial" color="#0000ff" size="2"> We have clinical trials of new EGFR agents in the US. There are also other chemotherapy drugs <font color="#f73809">问：一旦耐药发生，你们怎么处理？答：有其他的靶向药的临床试验，以及其他的化疗药物可供选择。</font></font></span></div><div style="FONT-SIZE: 12pt; FONT-FAMILY: times new roman, new york, times, serif;"> </div><div style="FONT-SIZE: 12pt; FONT-FAMILY: times new roman, new york, times, serif;">Question 4.  Which chemotherapy plan (the drug combinations) is the most commonly used for adenocarcinoma (age 66, female) in the practice here?  <span class="313542213-11072007"><font face="Arial" color="#0000ff" size="2"> Many different ones used.<font color="#ff6600">问：腺癌最常用的化疗方案？答：有很多选择。</font> </font></span>How do you feel about NP plan?<span class="313542213-11072007"><font face="Arial" color="#0000ff" size="2">  don't know what NP means <font color="#f73809">问：你对NP方案怎么看？答：不知道NP什么意思。</font></font></span></div><div style="FONT-SIZE: 12pt; FONT-FAMILY: times new roman, new york, times, serif;"> </div><div style="FONT-SIZE: 12pt; FONT-FAMILY: times new roman, new york, times, serif;">Question 5.  About the time to start Iressa.  In China, doctors apply Iressa (or Tarceva) as 3rd line treatment for NSCLC, since anyway Iressa resistance would happen, and once it happens, the disease would progress really fast, so they start Iressa after all other treatments fail, in which way the patient's survival time could be the maximum length.  This is different than here, that the EGFR targetted drug is used as 1st line treatment.  Does this mean that the survival time here would be shorter?<span class="313542213-11072007"><font face="Arial" color="#0000ff" size="2">  No - we think survival can be prolonged w/ iressa, especially if there is an EGFR mutation. the thing about the disease progressing faster is just not true.<font color="#f70909"> 问：在中国，靶向药物被用来作为非小细胞肺癌的三线治疗方案，在其他方案失效之后才用。医生们认为这会最大程度的延长病人生存时间，而在这里，靶向药被用于一线治疗，这意味着病人的生存时间会更短吗？答：我们认为易瑞莎能够延长生存时间，尤其是存在EGFR突变的情况下，，所谓易瑞莎耐药之后病情发展会更迅速的说法并不准确</font></font></span></div>

[此贴子已经被作者于2007-8-19 16:25:11编辑过]

gy1025 · 发表于 2007-8-19 23:11:06

长知识

See · 发表于 2007-8-20 12:17:35

Thank you so much, <strong><font face="Verdana" color="#61b713">campion!</font></strong>

无香 · 发表于 2007-8-20 17:00:20

<font color="#f70909" size="2"><font color="#000000">请问大家知道做</font>EGFR突变检查费用是多少吗？？</font>

jimizz · 发表于 2007-8-20 22:34:26

<p>我妈妈在江苏省中医院做的，900元、不过很多医生说这个测试世界并没有标准。</p>

See · 发表于 2007-8-20 23:01:53

<div class="msgheader">QUOTE:</div><div class="msgborder"><b>以下是引用<i>lantian</i>在2007-8-19 6:23:31的发言：</b><br/><p>谢谢see，</p><p>类癌，是肺癌里的一种；类癌又分不典型类癌，和典型类癌。据说得肺癌的人中只有1~2%的是类癌，我也是看了病理才知道有这种病，不知坛子里有没有同类的病友？</p><p>不典型类癌的英文名字是Atypical carcinoid，家人的现象是：双肺多发结节，最大的2.3x2cm，局部淋巴肿大，多发的骨转移（肺部没有什么症状，是由于脚疼走不了路去检查发现的）。医生说，目前的状况，不能手术，这种病对化疗也不敏感，由于得这种病的人少，医生也没什么经验。好象是没治疗办法了。</p><p>如果您方便的话，能不能帮忙问一下国外的医生哪种靶向药有用呢，谢谢啦！</p><p></p><br/></div><p></p><p>Hi lantian,</p><p>The doctor didn't answer in detail, but there's some useful information.  看起来应该按小细胞处理。你可把这个作为参考，再咨询一下老专家。Here's the email___</p><div><font face="Tahoma" size="2"><span class="170333012-20082007">----- Original Message ----<br/><br/><style type="text/css"></style><div><font face="Tahoma" size="2"><span class="170333012-20082007">glad to hear this about your mom. Iressa is the treatment to stay on. Surgery is not recommended. </span></font></div><div><font face="Tahoma" size="2"><span class="170333012-20082007"></span></font> </div><div><font face="Tahoma" size="2"><span class="170333012-20082007">Your other friend should see an oncologist. Atypical carcinoid is similar to SCLC.</span></font></div><div><font face="Tahoma" size="2"><span class="170333012-20082007"></span></font> </div><div><font face="Tahoma" size="2"><span class="170333012-20082007"></span></font> </div><div><font face="Tahoma"><span class="170333012-20082007"></span></font><font face="Tahoma"><font size="2"><span class="170333012-20082007"><font face="Arial" color="#0000ff"> </font></span></font></font></div><div><font face="Tahoma"><font size="2"><span class="170333012-20082007"></span></font></font> </div><div><font face="Tahoma"><font size="2"><span class="170333012-20082007"></span></font></font> </div><div><font face="Tahoma"><font size="2"><span class="170333012-20082007"> </span>-----Original Message-----<br/><br/></font></font></div><blockquote><div style="FONT-SIZE: 12pt; FONT-FAMILY: times new roman, new york, times, serif;"><div style="FONT-SIZE: 12pt; FONT-FAMILY: times new roman, new york, times, serif;">Dear Dr. ,</div><div style="FONT-SIZE: 12pt; FONT-FAMILY: times new roman, new york, times, serif;"> </div><div style="FONT-SIZE: 12pt; FONT-FAMILY: times new roman, new york, times, serif;"></div><div style="FONT-SIZE: 12pt; FONT-FAMILY: times new roman, new york, times, serif;">Also, I have a friend whose parent has been diagnosed as "Atypical carcinoid", which is neither a NSCLC, nor a SCLC.  The doctors told her that they didn't know how to deal with this kind of cancer, since it's so rarely happened (only 1-2% of the lung cancers).  Can I ask whether you know of this kind of cancer and how should we treat it?  Should chemo be the choice?  Are there any EGFR targetting drug for this?</div><div style="FONT-SIZE: 12pt; FONT-FAMILY: times new roman, new york, times, serif;"> </div><div style="FONT-SIZE: 12pt; FONT-FAMILY: times new roman, new york, times, serif;">Thanks a lot!</div><div style="FONT-SIZE: 12pt; FONT-FAMILY: times new roman, new york, times, serif;"> </div><div style="FONT-SIZE: 12pt; FONT-FAMILY: times new roman, new york, times, serif;">Have a great week.</div><div style="FONT-SIZE: 12pt; FONT-FAMILY: times new roman, new york, times, serif;"> </div><div style="FONT-SIZE: 12pt; FONT-FAMILY: times new roman, new york, times, serif;">sincerely,</div></div></blockquote></span></font></div>

songh · 发表于 2007-8-21 15:10:58

See · 发表于 2007-8-22 03:02:28

<div class="msgheader">QUOTE:</div><div class="msgborder"><b>以下是引用<i>songh</i>在2007-8-21 15:10:58的发言：</b><br/><p>感谢你，ＳＥＥ！</p><p></p></div><p>希望会有帮助！</p>

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美国——肺癌 一线上靶向药

美国——肺癌一线上靶向药