求：特罗凯耐药后的治疗方案！！（妈妈2007年12月4日病逝！）

jli999

   东方：知道你母亲的症状有所缓解，真高兴。

   DCA我也买了，其它几个辅助药还没配齐，一切都在考虑中......

小路

西乐葆，问了沈洁，她摇摇头，好象不太认同。

jimmy112199

QUOTE:

以下是引用小路在2007-7-25 6:39:19的发言：
西乐葆，问了沈洁，她摇摇头，好象不太认同。

Tarceva +西乐葆 联合使用, 最初试验是2006，加州大学洛杉 矶分校一期试验(21人)，可 扩大适用范围(从10%到30%)，同 时显示延长抗药时间(我将论文副在后面，同时译出延长抗药时间部分)，后来论坛中有人试用于TARCEVA/IRESSA的抗药，有人说有用，但具体怎么作得不清楚，(我将论坛的片段副在下面，注意，--他IRESSA抗药后，加西乐葆后，已经3年稳定了)      但西乐葆和另一种药合用已证明对肠癌(？)抗药有用，是一种有效的防止抗药的辅助药物。目前TARCEVA+西乐葆联合用药的2期试验正在美国进行，我想如果印度版的 IRESSA+西乐葆能在一定程度上解决抗药问题，那将是非常有意义的。(以上资料是根据我的记忆，我再核实一下)。但西乐葆 副作用是，可诱发心脏病，

DCA 和TARCEVA联合用药，是一项开创性的工作，如 成功， 将是非常有意义的。(用过DCA的人，有人认为它实际上是一种化疗，ZD6474和某些化疗药联合用药可延长抗药时间)
如 成功，也可考虑印度版的 IRESSA+DCA。

[此贴子已经被作者于2007-7-25 10:14:08编辑过]

jimmy112199

这是TARCEVA+西乐葆论坛文摘：

Subject: RE: Tarceva With Celebrex
Date: 06/05/2007

 

On 6/6/2006 Priscilla wrote:

Anyone taking celebrex with tarceva? Please reply. My husband don just started taking celebrex with tarceva(150 mg) Don has stage 3b adenocarcinoma non small cell Lung cancer with pluerel enfusion. His tumor is inoperable and he has a bad cough at times. Taking celebrex is up lifting because it can prolong life. Any problems we should watch for? Is it working for you? Thank you. Priscilla wife to don.

Hi Priscilla, I am on Iressa - Tarceva's sister drug. Started on it for stage IV bronchoalveolar carcinoma (all through my lungs but no where else) in March 2004. I had a slight progression by May so was started on high dose celebrex (800 mgs/day) in June 2004 and have been basically stable ever since. It has worked for me.

What to look for: I put myself on a low salt diet to help protect my liver and kidneys and that is working. I bruise easier than I used to but have had no clotting or other issues. And, the high dose celebrex has nearly eliminated the leg cramps from the Iressa and my arthritis does not bother me at all anymore. :-)  Hope this helps, Beverly

riscilla，你好，,在2004年3月，我开始用的IRESSA-它赛瓦的妹妹药物.治疗第四阶段支气管癌(全部扩散到我的肺部,但没有扩散到其他地方) , 5月，我有轻微的进展，因此开始用高剂量来西乐葆( 800 MGS型/天) , 2004年6月 已基本稳定,从那时起，. 它对我一直有效. :要做什么： 我给自己对低盐饮食,以帮助保护我的肝和肾,这很有效. 比起我过去来，我容易挫伤,但已不凝血或其他事宜. , 高剂量西乐葆已接近消除IRESSA造成的腿部痉挛,我的关节炎不打扰我。 希望这有助于你，Beverly 原文链接 http://www.cancercompass.com/message-board/message/all,5578,0.htm

jimmy112199

  
  
      
 
  
  

我将文中重要部分译出： The researchers evaluated response rates after eight weeks, but patients stayed on the study until tumor progression. The longest duration of response was 95 weeks, Dr. Reckamp said, which is more than three times longer than the average duration of response for a patient with advanced lung cancer. 8周后，研究者评估有效率，,但患者继续进行(TARCEVA+西乐葆)研究,直到肿瘤进展. 最长的反应是95个星期, reckamp博士说, .这超过晚期肺癌患者的平均反应，3倍以上。 下面是原文： Celebrex-Tarceva Duo 'Promising' in Late-Stage Lung Cancer Trial
	By Michael   Smith,      MedPage Today Staff Writer                        June 01, 2006                                                                                                    Add Your Knowledge™                                    Additional Lung Cancer Coverage                                LOS ANGELES, June 1 — Celebrex (celecoxib), the Cox-2 inhibitor, and Tarceva (erlotinib), the epidermal growth factor-receptor (EGFR) inhibitor, have been teamed with some preliminary success to inhibit late-stage non-small-cell lung cancer. Action Points Advise patients who ask that resistance to the cancer drug Tarceva is thought to involve over-expression of cyclooxygenase-2; and the Cox-2 inhibitor Celebrex therefore might prove useful in treatment.                Note that in this preliminary, small study, the drug combination was safe and produced a clinical response in 33% of patients, more than would be expected with Tarceva alone.                Over-expression of Cox-2 in tumor cells was seen in preclinical studies to cause resistance to drugs like Tarceva, which block tumor cell growth by targeting the EGFR, according to Karen Reckamp, M.D., of the University of California at Los Angeles.                              Dr. Reckamp and colleagues hypothesized that combining Celebrex with Tarceva would improve response rates; and they initiated a Phase I study to find the optimal biological dose and establish the toxicity profile of the combination.                              As a secondary endpoint, the researchers included clinical response to the drug pairing.                                                           Typically, Dr. Reckamp said, about one patient in 10 responds to Tarceva alone. Yet with the combination, 33% had a partial clinical response, and an additional 24% achieved stable disease.                                                           "Tarceva alone is a great drug and has a lot of clinical benefits, but for a small proportion of patients," Dr. Reckamp said. "With this drug combination, we saw an increase in response rates, indicating we are overcoming some resistance."                              In the June 1 issue of Clinical Cancer Research, Dr. Reckamp and colleagues presented safety data on 21 participants with stage IIIB and/or IV non-small-cell lung cancer, who received increasing doses of Celebrex, from 200 mg to 800 mg twice daily, as well as 150 mg/day of Tarceva.                                                           The most common toxicities were rash and skin-related effects, reported by 86% of patients, but there were no dose-limiting toxicities and no cardiovascular toxicities related to the study drugs, the researcher found.                              One patient—in the group taking 200 mg twice daily of Celebrex—suffered a myocardial infarction, but the event was after he stopped taking the drug and thought to be unrelated, because he had a previous history of MI. He had been enrolled before the spate of warnings about cardiovascular risks of Celebrex.                                                           The optimal dose of Celebrex, measured by decrease in urinary prostaglandin E-M, was 600 mg twice a day.                                                           The researchers also reported response data for 21 of the patients; the other patient had his Celebrex interrupted following the FDA warning regarding cardiovascular safety.                                                           The researchers evaluated response rates after eight weeks, but patients stayed on the study until tumor progression. The longest duration of response was 95 weeks, Dr. Reckamp said, which is more than three times longer than the average duration of response for a patient with advanced lung cancer.                              The researchers are planning a Phase II study, expected to start later this year, to confirm the efficacy of the combination therapy and to try to increase their understanding of Tarceva resistance, Dr. Reckamp said.                                                                                                   Additional  Lung Cancer Coverage                                           Primary source: Clinical Cancer Research         Source reference: Karen Reckamp et al. "A Phase I Trial to Determine the Optimal Biologic Dose of Celecoxib When Combined with Erlotinib in Advanced Non-Small Cell Lung Cancer." Clin Cancer Res 2006;12: 3381-3388

[此贴子已经被作者于2007-7-25 10:05:02编辑过]

东方

jimmy：对于TARCEVA+西乐葆的专题研究希望能有权威的报告出来，这对使用TARCEVA的患者来说确实是一大福音，我也有考虑是否增服西乐葆。

小路

谢谢jimmy的介绍，见你的帖子说，给你的亲人也准备用DCA了，祝你成功！

tkmtt

东方，你好，我爸爸也在吃DCA，目前服用12天，咳嗽减少了、痰少了，略有乏力；今天加到22mg/kg/天，有口干的感觉，乏力加重，其他没有什么症状，我考虑还是继续这个量。希望多交流。