2013CCONSCLC课件.pptVIP

EGFR, epidermal growth factor receptor; TKI, tyrosine kinase inhibitor * * * 不能手术的患者，不良预后表现为状态不佳、体重减轻超过10%、男性社会性别 年龄不影响生存和治疗 * * * * * * * * * * BAC, bronchioloalveolar carcinoma 肺泡癌; LPA, lepidic predominant adenocarcinoma 胚层为主的腺癌; NOS; not otherwise specified 未作分型的; SCC, squamous cell carcinoma鳞癌; SCLC, small cell lung cancer小细胞癌; * * BPC, bevacizumab plus carboplatin and paclitaxel; HR, hazard ratio; NSCLC, non-small cell lung cancer; OS, overall survival; PC, paclitaxel and carboplatin * * CG, cisplatin plus gemcitabine; CP, cisplatin plus pemetrexed; NSCLC, non-small cell lung cancer; OS, overall survival; PFS, progression-free survival; SCCA, squamous cell carcinoma antigen The most convincing of these data are from the so-called JMDB trial, published by Dr. Scagliotti, in which I was the senior author, in 2008. ? This was a randomized trial of cisplatin/pemetrexed versus cisplatin/gemcitabine and as shown in the first curve above, there was no difference in the survival or progression-free survival between the study arms. But in the second and third curves there was a differential benefit based on histology. The pemetrexed arm was better for survival over gemcitabine/cisplatin in nonsquamous cell carcinoma, and the reverse was true in squamous cell carcinoma. This led the FDA in the United States to restrict the use of pemetrexed to nonsquamous histology. * * NSCLC, non-small cell lung cancer * CI, confidence interval; HR, hazard ratio; NSCLC, non-small cell lung cancer; OS, overall survival * * EGFR, epidermal growth factor receptor * * * NSCLC, non-small cell lung cancer CI, confidence interval; HR, hazard ratio; PFS, progression-free survival. Median OS: no significant difference between arms overall, and in patients with or without EGFR mutations * EGFR, epidermal growth-factor receptor; OS, overall survival; PFS, progression-free survival; TKI, tyrosine kinase inhibitor * PC, pemetrexed + cisplatin; EGFR, epidermal growth-factor receptor; OS, overa