特罗凯+反应停效果如何

amei

请问诸位有没有使用反应停+特罗凯的病友，我打算这二者联合使用，有没有知道一些相关信息的病友，能给与一些建议，谢谢大家

天龙川

amei 你好！

我父亲是只服用特罗凯。

关于加反应停之事，个人认为一定要慎之又慎！

毕竟那时咱们的亲人。

心情可以理解，但在用药上最好和主治大夫商量后再决定。

祝好！

天龙川

在网站里看到有同学谈到用西乐葆和特罗凯共用的，

也是为延长特罗凯的耐药时间。

你可以去查找一下！

amei

谢谢，关于西乐葆已经咨询了许多大夫，大多说连用没有明显增效，另外小样本事件在医学上不足以定论，所以暂时没有用，如果有连用效果很好的病友，也请多发表意见。

whitmouse

那有没有用易瑞沙和西乐葆一起联合起来用的呢??

jimmy112199

amei:
我查了一下， 没找到TARCEVA/IRESSA +反应停 的有关文献。已查到的文献有。
1)反应停用于晚期小细肺癌2期试药结果。
2)反应停用于晚期小细肺癌3期试药结果。
3)反应停和化疗联药试药结果。
另外查到病友自述。
1)IRESSA 耐药后反应停单药治疗为稳定。
2)IRESSA/TARCEVA 耐药后，由反应停+西乐葆+轻剂量传统化疗，效果不错，副反应不大。

我把有关文献列在下面，有时间我会把它们译成中文。

[此贴子已经被作者于2007-9-8 13:31:14编辑过]

jimmy112199

Phase II trial of maintenance daily oral thalidomide in patients with extensive-stage small cell lung cancer (ES-SCLC) in remission

Sub-category: Small Cell Lung Cancer Category: Lung Cancer Meeting: 2005 ASCO Annual Meeting

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Abstract No:	7166
Citation:	Journal of Clinical Oncology, 2005 ASCO Annual Meeting Proceedings. Vol 23, No. 16S, Part I of II (June 1 Supplement), 2005: 7166
Author(s):	M. M. Cooney, S. Subbiah, R. Chapman, A. Ness, K. Rutherford, G. Warren, J. Saltzman, T. Mekhail, N. Levitan, A. Dowlati
Abstract:	Background: The prognosis of patients with ES-SCLC remains poor despite a high initial response to chemotherapy. Cooperative group trials have shown in general a median survival of 9 months and a 1-year survival of 35% (E7593). Thalidomide has been shown to have antiangiogenic activity in preclinical models and angiogenesis is biologically important in SCLC. Methods: Patients who have achieved a partial or complete response to induction chemotherapy for ES-SCLC were enrolled on a multicenter phase 2 clinical trial. Thalidomide was given at a fixed dose of 200 mg orally daily until disease progression. Patients had to start thalidomide within 3-6 weeks of completion of initial chemotherapy. Sample size calculation was based on the ability to demonstrate a 60% survival rate at 1 year (20% more than historical controls). A total of 30 evaluable patients are needed per design. Results: As of 12/6/04 twenty-two patients have been enrolled. Median age is 63 (51-78). Initial first line chemotherapy consisted of cisplatin or carboplatin with etoposide in 20 pts and cisplatin/irinotecan in 2 patients. All patients had achieved a partial response to induction chemotherapy with no complete responses. Toxicity has been minimal. Two episodes of grade 1 neuropathy and 2 cases of grade 1 constipation were reported. One patient was removed from trial for pulmonary embolism. Eighteen patients are currently evaluable for survival analysis. Overall survival is 15.7 months with a 1-year survival of 60%. Conclusions: Our initial data using thalidoimde as maintenance therapy for ES-SCLC in remission are encouraging and accrual is continuing. Updated data will be presented at ASCO.

jimmy112199

Phase III Double-Blind, Placebo-Controlled Study of Thalidomide in Extensive-Disease Small-Cell Lung Cancer After Response to Chemotherapy: An Intergroup Study FNCLCC cleo04–IFCT 00-01

Jean Louis Pujol, Jean Luc Breton, Radj Gervais, Marie-Laure Tanguy, Elisabeth Quoix, Philippe David, Henri Janicot, Virginie Westeel, Sabine Gameroff, Jean Genève, Dominique Maraninchi

From the Centre Hospitalier Universitaire, Montpellier; Hôpital de Belfort, Belfort; Centre Régional de Lutte Contre le Cancer, François Baclesse, Caen; Service de Biostatistique et d'Information Médicale, Hôpital la Pitié-Salpêtrière, Assistance Publique des Hôpitaux de Paris; Hôpital du Kremlin Bicêtre, Assistance Publique des Hôpitaux de Paris; Bureau des Études Cliniques et Thérapeutiques, Fédération Nationale des Centres de Lutte Contre le Cancer, Paris; Hôpital Universitaire de Strasbourg, Strasbourg; Hôpital Universitaire de Clermont Ferrand, Clermont Ferrand; Hôpital Universitaire de Besançon, Besançon; and Institut Contre le Cancer Paoli Calmette, Marseille, France

Address reprint requests to Jean Louis Pujol, MD, PhD, Hôpital Universitaire Arnaud de Villeneuve, 34295 Montpellier Cedex 5, France; e-mail: jl-pujol@chu-montpellier.fr

Purpose: This randomized, double-blind, placebo-controlled phase III study aimed to determine whether thalidomide prolongs survival of patients with extensive-disease small-cell lung cancer (SCLC).

Patients and Methods: One hundred nineteen patients received two courses of etoposide, cisplatin, cyclophosphamide, and 4'-epidoxorubicin (PCDE). Responder patients who had recovered from chemotherapy toxicity were randomly assigned to receive four additional PCDE cycles plus thalidomide (400 mg daily) or placebo.

Results: After the first two PCDE cycles, objective response rate was 81.5%, and 92 patients were randomly assigned to placebo (n = 43) or thalidomide (n = 49). Median exposure duration to placebo was 4.5 months, and median exposure to thalidomide was 4.9 months. Patients treated with thalidomide had a longer survival compared with patients who received placebo, although the difference was not statistically significant (minimal follow-up, 3 years; median survival time, 11.7 v 8.7 months, respectively; log-rank test: hazard ratio [HR] = 0.74; 95% CI, 0.49 to 1.12; P = .16). Patients with a performance status (PS) of 1 or 2 who received thalidomide had a significantly longer survival (HR = 0.59; 95% CI, 0.37 to 0.92; P = .02). The disease also progressed slower in patients with PS of 1 or 2 receiving thalidomide (HR = 0.54; 95% CI, 0.36 to 0.87; P = .02), whereas the difference did not reach statistical significance for the whole population (HR = 0.74; 95% CI, 0.49 to 1.12; P = .15). Neuropathy occurred more frequently in the thalidomide group compared with the placebo group (33% v 12%, respectively).

Conclusion: Treatment with thalidomide was not associated with a significant improvement in survival of SCLC patients. There was pronounced heterogeneity in survival outcomes between groups of patients. Some benefit was observed among patients with a PS of 1 or 2 (exploratory analyses), deserving further studies targeting angiogenesis in this disease.

Supported by the French League Against Cancer.

Presented in part at the 42nd Annual Meeting of the American Society of Clinical Oncology, June 2-6, 2006, Atlanta, GA.

Authors' disclosures of potential conflicts of interest and author contributions are found at the end of this article.