卵巢癌的靶向治疗.pptVIP

/oncology Beyond Chemotherapy Saturday, February 7, 2009 1:00 PM - 2:30 PM San Antonio Marriott Riverwalk Ballroom LevelSalon ABC San Antonio, Texas Beyond Chemotherapy: Current and Future Molecular-Targeted Therapy in Ovarian Cancer This program is supported by an educational grant from Michael V. Seiden, MD, PhDPresident and Chief Executive OfficerFox Chase Cancer CenterPhiladelphia, Pennsylvania The Need for Molecular-Targeted Therapy GOG 111: Standard of Care Study design Cisplatin 135 mg2 IV over 24 hours + Paclitaxel 75 mg/m2 x 6 cycles (n = 184) Cisplatin 75 mg/m2 x 6 cycles + Cyclophosphamide 750 mg/m2 IV (n = 202) Patients with suboptimally debulked, stage III/IV epithelial ovarian cancer within 6 weeks of surgery (N = 386) McGuire W, et al. N Engl J Med. 1996;334:1-6. GOG 111: PFS and OS McGuire W, et al. N Engl J Med. 1996;334:1-6. Treatment No. ProgressionFree No. With Treatment Failure Total Median PFS, mos Cisplatin + cyclophosphamide 28 174 202 13 Cisplatin + paclitaxel 45 139 184 18 0 0.1 0.2 0.3 0.4 0.5 0.6 0.7 0.8 0.9 1.0 Months After Entry Into Study Proportion Surviving Progression Free 0 6 24 36 42 12 18 30 48 0 0.1 0.2 0.3 0.4 0.5 0.6 0.7 0.8 0.9 1.0 Months After Entry Into Study Proportion Surviving 0 6 24 36 42 12 18 30 48 Treatment No. Alive No. Dead Total Median Survival, mos Cisplatin + cyclophosphamide 65 137 202 24 Cisplatin + paclitaxel 86 98 184 38 PFS (P .001) OS (P .001) GOG 218: Potential New Standard of Care Primary endpoint: PFS measured by RECIST Secondary endpoints: OS, safety, QoL, translational objectives, response *Beginning in course 2 of chemotherapy. ?Beginning in course 7 of chemotherapy. ClinicalT. NC Patients with stage III/IV ovarian or primary peritoneal cancer and GOG PS 0-2 entered 1-12 weeks after initial surgery (N = 2000) Paclitaxel + Carboplatin + Placebo* Paclitaxel + Carboplatin + Bevacizumab* Paclitaxel + Carboplatin + Bevacizumab* Placebo? x 15 months Placebo? x 15 month