进展期胃癌化疗新进展（PPT155页）课件.ppt

DX方案 病例数：一线治疗晚期转移性胃癌55例 方 法： DX方案 ，即 Xeloda 1000 mg/m2 p.o. Bid, d1-14; DTX 36 mg/m2 i.v. d1,d8; q3w. 结 果：RR40.4% 。中位TTP 4.5个月, MST 12个月，主要的毒副反应为骨髓抑制，3/4度占36.4%,5例发热。 结 论：Xeloda + DTX治疗晚期转移性胃癌有效，耐受性较好。 Kim H ,et al. ASCO,2004, Abstract?4057 Xeloda治疗胃癌:安全有效 1. 口服方便，符合胃癌的生物学特点，疗效可靠，安全性好 ； 2. 可与目前证实的对胃癌有效的任一药物联合，特别是与PDD、 OXA和 E-ADM, 具有协同作用，正在取代5-FU成为联合方案基本用药； 3. 应用灵活，可根据联合药物以及患者的体质合理地改变给药方式和剂量。 5.含S-1化疗 - Center - PS - Unresectable vs recurent, adj Crx vs recurrent, no adj Crx R A N D O M I S A T I O N ARM A (Control) 5-FU civ 800 mg/m2 D1-5 q 4 weeks ARM B S-1 80 mg/m2 D1 - 28 q 6 weeks U N T I L P D Primary endpoint: Overall survival A vs B: non-inferiority, A vs C: superiority ARM C CPT-11 70 mg/m2 D1,15 CDDP 80 mg/m2 D1 q 4 weeks JCOG 9912 Trial Boku N, et al. Proc Am Soc Clin Oncol 2007 (#4513) JCOG 9912 Trial: Results 5-FU S-1 CP No. 234 234 236 Off-treatment (PD/Toxicity) 199/18 203/22 143/75 Response rate 9% 28% 38% PFS 2.9 m 4.2 m* 4.8 m* OS 10.8 m 11.4 m 12.3 m Boku N, et al. Proc Am Soc Clin Oncol 2007 (#4513) R A N D O M I S A T I O N ARM A S-1 40-60 mg bid for 28 d q6w ARM B PDD mg/m2 on D8 S-1 40-60mg bid for 21 d q 5 w U N T I L P D Primary endpoint: Overall survival (Superiority) Center PS Unresectable vs. recurrent SPIRITS Trial Results of SPRITS Trial S-1 S-1/PDD P-value Response 31% 54% .0018 PFS 4.0 mo 6.0 mo .0001 OS 11.0 mo 13.0 mo .0366 Country: 23 (US, Europe, South America, Ukraine) Primary Endpoint: Overall survival (Superiority) Patient accrual 1050 (completed in March, 2007) FLAGS Trial (First-Line Advanced Gastric Cancer Study) R A N D O M I Z E Type of disease (Locally advanced vs Metastatic 1 metastasis vs Metastatic 1 metastases) -