******在美国的 Jimmy 请进！******

jimmy112199

Source: Vanderbilt University Medical Center Date: June 7, 2004

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Lung Cancer, Colon Cancer, Cancer, Breast Cancer, Brain Tumor, Prostate Cancer

Avastin-Tarceva Combo Provides 'One-Two' Punch Against Lung Cancer

Science Daily — Results of the first clinical trial to combine two new targeted cancer drugs suggest that the combination may provide a powerful "one-two punch" against lung cancer, the nation's leading cancer killer.

The work, led by researchers at the Vanderbilt-Ingram Cancer Center in Nashville, Tenn., and The University of Texas M.D. Anderson Cancer Center in Houston, was presented at the 40th annual meeting of the American Society of Clinical Oncology in New Orleans.

Tumors were controlled among 85 percent of the 40 patients with advanced non-small cell lung cancer (NSCLC) who entered the Phase I/II trial of a combined regimen of bevacizumab (Avastin TM) and erlotinib (Tarceva TM).

在进入了第一阶段/第二阶段TARCEVA+AVASTIN试药的40例晚期非小细胞肺癌（ nsclc ）病人中，  肿瘤控制在85 ％

The response rate proportion of patients whose tumors shrank in size by more than half was about 20 percent, while median survival was 12.5 months. This compares to about 10 percent response and between six and eight months median survival with traditional therapy or erlotinib alone, said Alan Sandler, M.D., associate professor of Medicine and director of the lung cancer clinical program at Vanderbilt-Ingram.

肿瘤缩小规模超过一半的患者约20 ％ ，而存活 12.5个月。相比之下， 10 ％左右的反应和六至八个月存活--与传统疗法或erlotinib单药比，阿兰桑德勒，博士说--副教授，医学主任兼肺癌临床节目范德比尔特-在ingram 。

The treatment resulted in only mild side effects, including rash and diarrhea, and the drugs did not appear to interact adversely with one another, the investigators report.

"The anti-tumor activity was encouraging," said Sandler, who presented the research at the meeting. "These findings suggest not only that combining these two agents is feasible, but that this approach may provide a one-two punch against tumors that should be further examined in larger clinical trials."

Lung cancer is the leading cause of cancer death in the United States, killing more than 157,000 people each year, more than the next four leading cancers (colorectal, breast, prostate and pancreas) combined. About 85 percent of all lung cancers are non-small cell cancers, and nearly half of these patients are diagnosed with advanced disease and receive only chemotherapy or supportive care, the investigators say.

Despite newer third-generation chemotherapies, most of these patients become resistant to treatment or develop side effects so severe that they cannot continue treatment. "Less toxic and more effective treatments are clearly needed," Sandler said. The two drugs, both delivered orally, are among newer so-called targeted cancer agents that focus on specific molecular features of cancer cells. Because they potentially target cancer cells while sparing healthy cells, the hope for these new agents is more effective cancer therapy with fewer side effects.

Bevacizumab blocks the vascular endothelial growth factor (VEGF), which is involved in making new blood vessels (a process called angiogenesis) that help feed tumor growth and spread. Erlotinib inhibits the epidermal growth factor receptor (EGFr), a key player in delivery of signals that prompt the runaway cell growth that characterizes cancers.

Increased activity of the EGFr pathway, as well as increased number of tumor blood vessels resulting from VEGF expression, are associated with poorer outcomes for patients with NSCLC, the investigators note.

Other research has suggested that activities of EGFr and VEGF are related EGFr appears to play a role in angiogenesis, while blocking VEGF appears to interrupt EGFr signaling. As a result, the researchers suspect that a dual blockade of these targets may be synergistic. Interim results from this research were presented at last year's ASCO meeting in Chicago, prompting other investigators across the country to examine this combination in other tumor types as well as combine other targeted agents in clinical trials, Sandler said.

At the time the study was launched, it was the first time two drugs that had not yet been approved by the U.S. Food and Drug Administration were combined in a trial. Since that time, bevacizumab has been approved for use in advanced colorectal cancer in combination with chemotherapy. Erlotinib is pending FDA approval.

Co-investigators include Roy Herbst, Eric Mininberg, Ted Henderson, Edward Kim, George Blumenschein Jr., Jack Lee, Mylene Truong, and Waun Hong of M.D. Anderson; David Johnson and David Carbone of Vanderbilt-Ingram; Ben Garcia of the University of Texas Southwestern Medical Center; and Dong Xie and Sean Kelley of Genentech Inc., which makes both drugs and funded the clinical trial.

Note: This story has been adapted from a news release issued by Vanderbilt University Medical Center.

lantian

请问jimmy，TARCEVA+AVASTIN， AVASTIN+传统化疗：针对吃易耐药的人群是否可以受宜呢？

amei

谢谢大家的分享，特别谢谢jimmy总是及时地为我们反馈国外的新动态。

to zhizhi:

  罗氏开始赠药了么，真高兴听到这个消息，知道细节的朋友能给与后续报道么？

to 大家：

   西乐葆和特罗凯连用的事情曾经咨询过我们的主治医师，说国内没有此项研究，另外听说西乐葆在欧洲已经叫停，说是其副作用显著，诱发心脏病后果严重。所以诸位病友如果打算连用的话，请详细咨询，甚用。

另外我们的主治医生说,HKI-272对于易瑞沙耐药和无效的病友是一个不错的选择，如果有关于HKI-272最新消息的病友，期待能及时分享。

小路

to jimmy

谢谢jimmy及时的鼎力相助！“易”已耐药。现已开始用“特萨瓦”。如果“特萨瓦”再耐药的话，准备用avstin加“特萨瓦”。好在avstin通过互网可以买到。

[此贴子已经被作者于2007-9-14 10:01:15编辑过]

小路

to jimmy

我查了一些资料与你和大家分享。

 美国Vanderbilt大学Ingram癌症中心的Alan Sandler博士正在从事这方面的研究。在他所主持的一项有40名非小细胞肺癌患者参加的Ⅱ期临床试验中，Tarceva+avastin联合治疗的患者肿瘤消退程度达到一半的患者比例有22%，中位生存期达到了12.5个月。和历史数据相比，这个结果相当令人鼓舞。而早期的研究表明，两药单独使用的话，反应率大约为20%，中位生存期为6-8个月。当然这毕竟是一项小规模的临床试验，就此下结论还为时过早。目前只有Ingram癌症中心和MD安德森癌症研究中心在从事这两种药物联合治疗的研究，而且鳞状细胞癌还被排除在试验之外。Alan Sandler的下一步计划是将Tarceva和avastin加入和传统化疗方案联合使用。比如紫杉醇+卡铂+avastin治疗4-6个周期后再进行Tarceva+avastin治疗。这项研究很令人期待，

小路

因为Tarceva和Iressa和传统化疗药联合使用都没有显示出提高化疗反应率的效果，那么Tarceva和avastin联合使用是否能提高化疗效呢？种化疗药物联合使用时常常会引起更大的副作用，病人的耐受性将成为一个突出的问题。所幸的是，Tarceva+avastin联合给药并没有加大副作用。在上述两项试验中，两种药物都用了完全剂量，最常出现的不良反应是皮疹和腹泻（Tarceva和其他EGFR抑制剂常引起的不良反应），两者都可控制。Sandler的试验中有部分病人出现了轻度的血压升高（与avastin有关）

小路

据罗氏透露：avastin在09年年底，才能正式在大陆上市。

lantian

QUOTE:

以下是引用小路在2007-9-14 9:54:58的发言：

to jimmy

谢谢jimmy及时的鼎力相助！“易”已耐药。现已开始用“特萨瓦”。如果“特萨瓦”再耐药的话，准备用avstin加“特萨瓦”。好在avstin通过互网可以买到。

小路，很吃惊您吃易已耐药了么？看到资料上有易转特萨wa，一般可以坚持三个月的。

请问怎样从互联网买药呢？