唑来膦酸的抗肿瘤作用.ppt

* Zarogoulidis et al: ZOL improved survival and time-to-disease progression in advanced NSCLC patients1 Zarogoulidis et al examined the impact of ZOL on the survival, time-to-disease progression, and pain effect in NSCLC patients with bone metastases. 144 stage IV NSCLC patients with evidence of metastasis were randomised into 2 treatment arms: 87 received ZOL 4 mg IV every 21 days and 57 received no ZOL (control). All patients were treated with a combination of docetaxel 100 mg/m2 and carboplatin AUC=6. ZOL significantly improved median OS by 50% (P0.001) ZOL significantly improved median time-to-disease progression by 77% (P0.001) A statistically significant positive correlation was found between the number of cycles of therapy with ZOL and total patient survival (P0.01) and time-to-disease progression (P0.01) Adverse events associated with ZOL were generally well tolerated and manageable. The investigators concluded that these positive results should be further investigated to support the usefulness of ZOL as an anticancer therapeutic option in the treatment of NSCLC. Reference: 1. Zarogoulidis K et al. Int J Cancer. 2009. Epub DOI: 10.1002/ijc.24470. * * * * * * ZO-FAST (60个月)相比延迟ZOL治疗初始ZOL治疗降低DFS发生风险达34% a 对于同一名患者可能报告有多个部位. 远处转移包括有: 骨, 脑, 肝, 肺, 皮肤, 淋巴结以及其他部位. 缩写: DFS,无病生存率; HR,风险比; ZO-FAST,择泰-弗隆辅助的协同试验; ZOL,唑来膦酸. Reprinted from de Boer R, et al. SABCS 2010, poster P5-11-01. 疾病复发a 绝对差 = 19 DFS 100 90 80 70 60 50 40 30 20 10 0 无病生存率 % 0 6 12 18 24 30 研究时间（月） 36 42 48 54 60 66 HR = 0.66; 对数秩 P 值 = .0375 前期使用 ZOL 4 mg (42个事件) 延迟使用 ZOL 4 mg (62个事件) 532 533 518 511 500 491 488 475 475 463 376 368 前期使用ZOL 延迟使用ZOL 风险数量 53 34 AZURE：乳腺癌辅助试验 研究终点： 主要终点：无病生存 (DFS) 其他：无浸润性疾病生存(IDFS)，骨转移/远处转移的时间，SREs，总体生存率 标准治疗: 化疗 ± 内分泌治疗;. 缩写: BC, 乳腺癌; ER,雌二醇受体; IDFS, invasive 无病生存率; IV, 静脉内; mets, 转移; R, 随机; SREs, 骨骼相关事件; ZOL,唑来膦酸. Coleman RE, et al. Br J Cancer. 2010;102(7):1099-1105. 标准治疗 标准治疗 + ZOL静脉内4mg 6 剂 (每3-4周) 8 剂 (每3个月) 5 剂 (每6个月) N = 3,360 乳腺癌分期 II/III 分层： N+/N