有效的非小细胞肺癌治疗的基础-Nicholas Thatcher-2009CSCO年会PPT.ppt

DISEASE CONTROL RATE IN SAIL STUDY DCR was 88.7% for the overall population Response rates* (%) 100 50 0 2.8 48.0 37.9 88.7 DCR SD CR PR *Percentage is based on the number of patients with tumour assessment (n=1,956 [90.3%]) CR = complete response; PR = partial response; SD = stable disease Thatcher et al WCLC 2009 abst C2.4 TOLERABILITY OF AVASTIN-BASED THERAPY CONFIRMED Grade ≥3 AEs of special interest in E4599, AVAiL and SAiL E4599 Avastin 15mg/kg + CP AVAiL Avastin 15mg/kg + CG AVAiL Avastin 7.5mg/kg + CG SAiL Avastin 7.5 or 15mg/kg + chemotherapy Bleeding Incidence (%) 50 45 40 35 30 25 20 15 10 5 0 Hypertension Proteinuria Febrile neutropenia Arterial thrombosis 4 7 3.1 5.2 1.9 4 9 1 2 3 6 0.3 2 2.4 2.2 3.6 0.8 0 5.4 4.4 Extensive experience with Avastin-based therapy (350,000 patients treated in routine clinical setting across indications) Crino et al ASCO 2009 abst 8043 1Sandler et al. N Engl J Med 2006; 2Dansin et al. ASCO 2008 abs 8085 3Reck et al J Clin Oncol 2009 GETTING PATIENT ELIGIBILITY RIGHT:– reduced grade ≥3 haemoptysis ?1.5% Non-squamous cell histology only with no significant haemoptysis at baseline E45991 No tumour invasion of major blood vessels SAiL3 Same patients as in AVAiL 0.2% AVAiL2 Similar to baseline risk of lung cancer patients 2.3% SAFETY (AES OF SPECIAL INTEREST – GRADE ≥3) FOR PATIENTS WITH HTN VERSUS THOSE WITHOUT HTN events (%) Patients without HTN eventN=1,586 Patients with HTN eventN=580 Safetypopulation N=2,166 Grade 1-2 0 98.4 26.4 Grade 3-5 0 1.6 0.4 AE (%) Bleeding Epistaxis Haemoptysis Pulmonary haemorrhage Other bleeding 0.6 0.6 0.3 0.6 0.9 0.0 0.0 0.2 0.7 0.4 0.2 0.5 Proteinuria 0.0 0.3 0.1 Thromboembolism 5.0 4.0 4.8 Congestive heart failure 1.2 0.5 0.1 Gastrointestinal perforation 1.1 0.3 0.9 CNS bleeding 0.2 0.2 0.2 Thatcher et al WCLC 2009 abst C2.4 EFFICACY FOR PATIENTS WITH HTN VERSUS THOSE WITHOUT Patients without HTN event N=1,586 Patients with