易瑞沙耐药后的解决方案，请大家都来找出路

jimmy112199 · 发表于 2007-6-3 03:25:25

Remarkable Effect of
Gefitinib Retreatment in a Patient with Nonsmall Cell Lung Cancer Who Had a
Complete Response to Initial Gefitinib.
<op></op>

Case Reports
<op></op>

American Journal of the
Medical Sciences.    333(4):221-225, April 2007. 
   Yoshimoto, Akihiro MD;  Inuzuka, Kanako
MD;  Kita, Toshiyuki MD;  Kawashima, Atsuhiro MA,
MD;  Kasahara, Kazuo MD    <op></op>

 
Abstract:
 
Gefitinib is an orally active epidermal growth factor receptor tyrosine kinase
inhibitor, and it shows favorable antitumor activity against chemorefractory
nonsmall cell lung cancer (NSCLC). However, patients with NSCLC have few
treatment options available if they are refractory to gefitinib. We describe a
49-year-old patient with NSCLC who had a complete response to initial gefitinib
that lasted for 12 months. The tumor relapsed, and the patient received
cytotoxic chemotherapy. However, despite chemotherapy, the patient had
radiographic progression of lung metastases and we commenced retreatment with
gefitinib, showing a remarkable effect. Epidermal growth factor receptor (EGFR)
gene analysis showed deletion mutations in codon 745-750 in exon 19 and EGFR
gene amplification. Our case shows that after retreatment with gefitinib,
patients may show a remarkable response if they showed a remarkable response to
initial gefitinib administration and if a certain time has elapsed since the
previous gefitinib treatment.<op></op>

(C) Copyright 2007 Southern Society for
Clinical Investigation <op></op>

非小细胞肺癌患者初次用iressa有完全疗效，抗药后再次用药，效果显著<op></op>

 报告病例<op></op>

美国杂志的医学科学.
333 ( 4 ) :221 - 225 , 2007年4月. 

作者：yoshimoto ,昭裕医生; inuzuka , kanako 医生 ; 基塔,
toshiyuki 医生
; 川岛,曝露马, 医生 ;
kasahara ,喀左，医生<op></op>

摘要: 

gefitinib是一种口服活跃表皮生长因子受体酪氨酸激酶抑制剂, 而且对于化疗抗药的非小细胞肺癌病人，显示了良好得疗效 . 不过,
如果非小细胞肺癌患者对iressa 抗药，他们只有很少的治疗方法可选择。
我们描述一位49岁的非小细胞肺癌病人，他第一次的iressa治疗有完全疗效, 历时12个月. 肿瘤复发,病人接受化疗. 但是,尽管化疗,病人已有radiographic
progression肺转移,我们开始再次使用iressa,
呈现出显着的效果. 表皮生长因子受体( EGFR )基因分析发现缺失突变745-750密码子19和EGFR基因扩增. 

<op> </op>

我们的个案显示, 如果患者第一次用iressa有显着的效果，从上次iressa治疗后，<op></op>

某个
时间已经过去, 再用iressa
之后, 他们仍会出现明显的疗效.

<op> </op>

 ( c )版权2007南社临床调查

jimmy112199 · 发表于 2007-6-3 03:26:25

A Case of Adenocarcinoma
of the Lung with a Favorable Response to Retreatment with Gefitinib<op></op>

Hideki Shibuya1), Tomoko Kutomi1),
Yoko Sato1), Naoki Tashiro1), Kei Hara1) and
Tetsuya Hisada1)<op></op>

1) Department of Respiratory Medicine, <st1place><st1placename>Tokyo</st1placename>
<st1placename>Teishin</st1placename>
<st1placetype>Hospital</st1placetype></st1place><op></op>

(Received <st1date year="2006" day="2" month="3">March 2, 2006</st1date>) 
(Accepted <st1date year="2006" day="26" month="4">April 26, 2006</st1date>)<op></op>

Abstract  Background. Gefitinib showed
response rate of 10-20% in chemorefractory non-small cell lung cancer cases,
while even in patients who responded, tumor recurrence Case of Adenocarcinoma of the Lung with a Favorable
Response to Retreatment with Gefitinib<op></op>

Hideki Shibuya1), Tomoko Kutomi1),
Yoko Sato1), Naoki Tashiro1), Kei Hara1) and
Tetsuya Hisada1)<op></op>

1) Department of Respiratory Medicine, <st1place><st1placename>Tokyo</st1placename>
<st1placename>Teishin</st1placename>
<st1placetype>Hospital</st1placetype></st1place><op></op>

(Received <st1date year="2006" day="2" month="3">March 2, 2006</st1date>) 
(Accepted <st1date year="2006" day="26" month="4">April 26, 2006</st1date>)<op></op>

Abstract  Background. Gefitinib showed
response rate of 10-20% in chemorefractory non-small cell lung cancer cases,
while even in patients who responded, tumor recurrence can appear during the
therapy. There are only a few reports about patients successfully retreated
with gefitinib. Here we report a case of adenocarcinoma of the lung with a
favorable response to retreatment with gefitinib. Case. A
37-year-old woman presented with left chest pain, cough, and dyspnea on
exertion in February 2004. Her chest radiograph and CT revealed multiple
nodular shadows throughout both lung fields. Adenocarcinoma of the lung was
diagnosed (cT1N2M1). Because of progressive disease after two courses of
chemotherapy with cisplatin and gemcitabine, she was given gefitinib therapy in
May 2004 and a partial response was achieved. However, gefitinib was
discontinued after 6 months of treatment, due to regrowth of the tumors. The
tumors continued to grow even after further chemotherapy (four courses of
cisplatin and docetaxel, followed by three courses of carboplatin and
paclitaxel). She was retreated with gefitinib in June 2005, with a partial
response once again. Conclusion. Retreatment with gefitinib may
yield good results in patients with non-small cell lung cancer who are
refractory to chemotherapy.<op></op>

一个肺腺癌抗药后再用 iressa
(gefitinib) 取得良好结果的病例<op></op>

作者： Hideki Shibuya , tomoko
kutomi， yoko sato , naoki tashiro ,
Kei Hara，tetsuya hisada <op></op>

东京通信医院呼吸内科医学科， 2006年3月2日(收到)
(2006年4月26日接纳)<op></op>

" --摘要—"背景.<op></op>

在对化疗抗药的非小细胞肺癌病人中，10-20%的病人用
iressa 治疗是有效的<op></op>

然而即使是这些病人，仍可以出现在治疗中肿瘤进展(--即抗药). 目前只有寥寥可数的关于患者抗药后，再次用药成功的报道. 在这里, 我们介绍
一例肺腺癌抗药再次用药成功例子。<op></op>

案例：
一位37岁的女性,左胸部疼痛, 咳嗽及呼吸困难，劳累, 起于2004年2月. 她的胸部X光及电脑断层检查发现多处结节影，遍布整个双肺. 诊断为肺腺癌 (
ct1n2m1 ) .两个疗程后(顺铂和健择) ，由于病情发展, 2004年5月，她接受IRESSA治疗，取得了局部的疗效. 不过，6个月的治疗后, 因
肿瘤开始继续增长, , 中断IRESSA治疗。以后再化疗(四门疗程铂和紫杉醇, 接着由三个疗程铂与紫杉醇) 肿瘤无法控制，继续增长，她于2005年6月再次接受IRESSA治疗, 再次取得了局部的疗效.<op></op>

结论. ,在治疗对化疗抗药的非小细胞肺癌时，iressa (gefitinib)  抗药后再用，仍可能取得好的效果<op></op>

jimmy112199 · 发表于 2007-6-3 04:23:15

<h1>Retreatment of Lung Adenocarcinoma Patients With Gefitinib Who Had
Experienced Favorable Results From Their Initial Treatment With This Selective
Epidermal Growth Factor Receptor Inhibitor: A Report of Three Cases </h1>

Authors: Yano, Seiji<a href="http://www.ingentaconnect.com/content/cog/or/2005/00000015/00000002/art00006;jsessionid=1q470ulh8a3ce.alice?format=print#aff_1">1</a>; Nakataki,
Emiko<a href="http://www.ingentaconnect.com/content/cog/or/2005/00000015/00000002/art00006;jsessionid=1q470ulh8a3ce.alice?format=print#aff_1">1</a>; Ohtsuka,
Shinsaku<a href="http://www.ingentaconnect.com/content/cog/or/2005/00000015/00000002/art00006;jsessionid=1q470ulh8a3ce.alice?format=print#aff_1">1</a>; Inayama,
Mami<a href="http://www.ingentaconnect.com/content/cog/or/2005/00000015/00000002/art00006;jsessionid=1q470ulh8a3ce.alice?format=print#aff_1">1</a>; Tomimoto,
Hideki<a href="http://www.ingentaconnect.com/content/cog/or/2005/00000015/00000002/art00006;jsessionid=1q470ulh8a3ce.alice?format=print#aff_1">1</a>; Edakuni,
Nobutaka<a href="http://www.ingentaconnect.com/content/cog/or/2005/00000015/00000002/art00006;jsessionid=1q470ulh8a3ce.alice?format=print#aff_1">1</a>; Kakiuchi,
Soji<a href="http://www.ingentaconnect.com/content/cog/or/2005/00000015/00000002/art00006;jsessionid=1q470ulh8a3ce.alice?format=print#aff_1">1</a>; Nishikubo,
Naoki<a href="http://www.ingentaconnect.com/content/cog/or/2005/00000015/00000002/art00006;jsessionid=1q470ulh8a3ce.alice?format=print#aff_1">1</a>; Muguruma,
Hiroaki<a href="http://www.ingentaconnect.com/content/cog/or/2005/00000015/00000002/art00006;jsessionid=1q470ulh8a3ce.alice?format=print#aff_1">1</a>; Sone,
Saburo<a href="http://www.ingentaconnect.com/content/cog/or/2005/00000015/00000002/art00006;jsessionid=1q470ulh8a3ce.alice?format=print#aff_1">1</a>

Source:
<a title="Oncology Research Incorporating Anti-Cancer Drug Design" href="http://www.ingentaconnect.com/content/cog/or;jsessionid=29ifcrl5qcein.alice">Oncology
Research Incorporating Anti-Cancer Drug Design</a>, Volume 15, Number 2,
2005, pp. 107-111(5)

ublisher: <a title="publisher" href="http://www.ingentaconnect.com/content/cog;jsessionid=29ifcrl5qcein.alice">Cognizant Communication Corporation</a>

Abstract:

Gefitinib is a selective inhibitor of epidermal growth
factor receptor (EGFR) tyrosine kinases, and shows favorable antitumor activity
against chemorefractory non-small cell lung cancer (NSCLC). The majority of
responders (patients who are sensitive to gefitinib), however, relapse within
1.5 years, indicating an acquired resistance to gefitinib. Here we report three
chemotherapy refractory NSCLC patients who were retreated with gefitinib. All
three cases were nonsmokers and showed an adenocarcinoma histology. While they
had experienced successful control from their initial treatment with gefitinib
for more than 12 months, gefitinib therapy was terminated because two cases
(cases 1 and 3) relapsed during the therapy and case 2 suffered alveolar
hemorrhage. After more than 7 months from the time of discontinuation of the
initial gefitinib treatment, they were retreated with gefitinib, as further
tumor progression was observed. Of the three cases, cases 1 and 2 were well
controlled by retreatment with gefitinib monotherapy for more than 7 months,
suggesting sensitivity to retreatment. Case 3 also showed a regression in size
of several tumors, while some other lesions progressively enlarged and
developed a malignant pleural effusion after 4 months. These observations
suggest the possibility that retreatment with gefitinib might be useful when 1)
initial treatment shows a favorable clinical response, and 2) there has been a
period of time following the termination of the initial gefitinib treatment. 

Keywords:
<a href="http://www.ingentaconnect.com/search;jsessionid=29ifcrl5qcein.alice?database=1&title=Retreatment">Retreatment</a>;
<a href="http://www.ingentaconnect.com/search;jsessionid=29ifcrl5qcein.alice?database=1&title=Acquired%20resistance">Acquired
resistance</a>; <a href="http://www.ingentaconnect.com/search;jsessionid=29ifcrl5qcein.alice?database=1&title=Gefitinib">Gefitinib</a>;
<a href="http://www.ingentaconnect.com/search;jsessionid=29ifcrl5qcein.alice?database=1&title=Lung%20cancer">Lung
cancer</a>; <a href="http://www.ingentaconnect.com/search;jsessionid=29ifcrl5qcein.alice?database=1&title=Alveolar%20hemorrhage">Alveolar
hemorrhage</a>


Document Type: Research article 

Affiliations:
1: <a name="aff_1"></a>Department
of Internal Medicine and Molecular Therapeutics, The University of Tokushima
Graduate School, <st1date month="3" day="18" year="2015">3-18-15</st1date>
Kuramoto-cho, <st1place><st1city>Tokushima</st1city>, <st1country-region>Japan</st1country-region></st1place>

肺腺癌患者iressa抗药后再用药的3例报告(如果患者最初对这种选择性表皮
生长因子受体抑制剂曾经历了较好的疗效)<op></op>

作者:雄, seiji1 ; nakataki , emiko1 ;
ohtsuka , shinsaku1 ; inayama , mami1 ; tomimoto , hideki1 ; edakuni ,
nobutaka1 ; kakiuchi , soji1 ; nishikubo , naoki1 ; muguruma , hiroaki1 ; sone
, saburo1

来源:肿瘤研究,将抗癌药物的设计 15卷,第2号, 2005年, pp . 107-111 ( 5 )

出版商: cognizant通信公司<op></op>

摘要: 

gefitinib是一种选择性抑制表皮生长因子受体(
EGFR )酪氨酸激酶，<op></op>

对化疗耐药的非小细胞肺癌(NSCLC) 具有良好的效果。然而，
大多数对iressa反应良好的
病人 , 在1.5年复发。这
表明对iressa抗药了 . 在这里我们报告三个化疗难治肺癌病人，<op></op>

重用iressa的例子. 三人是非吸烟者，并呈现出腺癌组织，. 虽然他们最初的iressa治疗，成功的控制病情超过12个月, 但iressa治疗被终止,

因为两例(病例1和3 ) 在治疗中病情复发了，案例2蒙受肺泡
出血. 从停止了最初的iressa治疗，经过超过7个月的时间，他们重新使用iressa ,作为进一步预后观察. 上述三个案件
例1和第2名的用iressa单药治疗，控制超过7个月, 提示重新使用iressa是有效的，. 案例3也显示了几个肿瘤的缩小，但
另一些病变逐渐扩大，4个月后,形成了恶性胸水. 这些情况提示了一种可能性,--再用iressa可能是有用的,
如果<op></op>

1)   初步治疗,显示了良好的临床
反应, 

2 )
最初iressa治疗抗药停药后. 已经有一段时期. 

<op> </op>

关键词: retreatment ; 获得抗性;
gefitinib ; 肺癌;
肺泡出血文件类型<op></op>

:研究论文背景: 

1 : , 徳島大学研究生院，内科医药和分子疗法系, <st1date month="3" day="18" year="2015">3-18-15</st1date> Kuramoto-cho，徳島市 ,日本

妈妈健康 · 发表于 2007-6-3 07:35:17

希望能看到更多的信息,谢谢大家!

clough · 发表于 2007-6-3 11:01:06

看了这些病例,受到了一些鼓舞,上面这些病例中,从停止到再次使用的时间大概半年左右,我父亲2007年3月26日停IRESSA,经过两个疗程的CO+恩度方案，显示病情没有明显进展,但有部分变化,我们决定从2007年6月3日重新开始服用IRESSA+反应停.停药大概只有2个月的时间,是不是时间间隔的太少了? 矛盾ing.

jimmy112199 · 发表于 2007-6-3 12:23:07

clough：     还有2篇没翻译，其中一篇讨论了27个病例，时间间隔0。6-7。8个月，0。6月的无效，但1。9月的是稳定。更长的也是稳定甚至缩小

4月蔷薇 · 发表于 2007-6-3 20:44:00

我妈妈正在服用英版易瑞沙，这些天一直关注抗药以后的用药方法。 jimmy112199：谢谢你给大家提供的信息，辛苦了~~

plan · 发表于 2007-6-4 12:43:14

我母亲吃了快9个月了，也在积极寻找耐药之后的方法

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易瑞沙 耐药后的解决方案，请大家都来找出路

易瑞沙耐药后的解决方案，请大家都来找出路