EGFR-KI在肺癌中的治疗.pptVIP

EGFR-TKI在肺癌一线治疗中的作用 同济医院肿瘤中心 张 莉 Contents Contents Contents * * * * * * * 上世纪40年代，化疗方案的出现；90年代，含铂两联方案的确定； * * The types of patients harbouring the mutation are similar between Asian and non-Asian patients. However, it should be noted that mutations are more prevalent in Asian patients. A literature review has shown that the most common activating mutations have a similar distribution between Asian and non-Asian patients.1 This similar distribution of activating mutations suggests that EGFR-TKIs will provide benefits in Asian and non-Asian patients with these mutations. Exon 18-21 encode Gefitinib binding domain. References AstraZeneca Data on File 2009 In particular, blood based (serum/plasma) testing is particularly attractive due to the ease of accessibility to samples, but the sensitivity of the methods currently used mean that identifying EGFR mutation positive patients from blood is still challenging ? AstraZeneca research suggests that of the patients who are identified as mutation positive by analysing their tumour, approximately 50% can be identified as mutation positive by analysing circulating free DNA (cfDNA) in blood. Data demonstrated a 0% false positive rate. ? For this reason, blood based testing may not replace biopsy-based testing in the near future. However, it could be used in addition to biopsy testing, for those patients for whom the physician does not have access to a sample * * 基本治疗模式 1 EGFR-TKI用于一线治疗 2 3 基因突变检测 传统治疗模式 IB期以上的NSCLC术后行四周期化疗 2. 辅助化疗失败的患者行一线、二线化疗 3. 无法手术切除的患者行一线、二线化疗 基本治疗模式 1 EGFR-TKI用于一线治疗 2 3 基因突变检测 吉非替尼与卡铂/紫杉醇两联化疗相比用于临床选择的晚期非小细胞肺癌患者的一线治疗的随机开放III期研究（IPASS）  莫树锦,1 吴一龙,2 Sumitra Thongprasert,3 杨志新,4 储大同,5 Nagahiro Saijo,6 Haiyi Jiang ,7 Claire Watkins,8 Alison Armour,8 Masahiro Fukuoka9 1香港中文大学; 2广东省人民医院; 3Maharaj Nakorn Chiang Mai Hospital, Chiang Mai, Thailand; 4台大医院; 5 中国医学科学院肿瘤医院; 6National Cancer Centre Hospital East, Chiba, Japan; 7AstraZeneca, Osaka, Japan; 8AstraZeneca, Macclesfield, UK; 9Kinki University,