转移性乳腺癌的内科治疗（squip）课件.pptVIP

转移性乳腺癌的化疗;NCCN 2006;蒽环类和紫杉类是主要化疗方案 蒽环类单药疗效40%左右。 紫杉类单药疗效33%-50%。 蒽环类与紫杉类联合疗效优于蒽环类为主的联合化疗。 首选的联合治疗方案 CAF/FAC/FEC/CMF AC/EC Paclitaxel+ADR Docetaxel+Xeloda Paclitaxel+Gemcitabine 首选的单药和其他有效的药物 蒽环类 、紫杉类、希罗达、NVB和健择。 铂类\VP-16(po)、VLB、5-FU (civ); HER2阴性转移性乳腺癌的一线治疗;卡培他滨 Capecitabine，Xeloda 长春花碱酰胺 Vinorebine 吉西他滨 Gemcitabine 铂类（Cisplatin, Carpoplatin）;希罗达和泰索帝联合与泰索帝单药对照治疗蒽环类失败的MBC  a large phase III trial;XT与Taxotere对照研究结果;Capecitabine in Taxane-pretreated Metastatic Breast Cancer;Gemcitabine in Anthracycline/Taxane-Refractory MBC;Vinorelbine in Refractory MBC; 蒽环类和紫杉类方案失败后的治疗选择，Xelo\NVB\GEM的疗效大致相当，但是毒性不同。三种药物之间没有直接对照的研究，选择时更注重避免毒性重叠。;After Anthracyclines and Taxanes: Multiple Options;Abraxane (ABI-007，楷素);每周凯素治疗紫杉类耐药MBC 两个Phase II Trial;Vinflunine（长春富宁） After Anthracycline and Taxane Failure in MBC;Ixabepilone (BMS-247550，埃坡霉素);Antitumor Activity in Taxane-Resistant PAT-21 Breast Cancer Xenografts;Clinical Response to Ixabepilone NCI-0229;Phase III Clinical Trials ofIxabepilone Plus Capecitabine;Conclusion;分子靶点药物临床研究;Targeting Dysregulated Pathways With Novel Agents;Strategies for ErbB Receptor Inhibition;Her2 过表达的MBC的治疗; ;赫赛丁单药治疗的客观疗效Study H0649g ;赫赛丁单药一线治疗MBC Study H0650  Response Rate;赫赛丁与化疗联合一线治疗MBC ORR (HO648g);Comparative Study HO648gOverall ORR;Comparative Study HO648gTime-to-Disease Progression;Overall survival;Mean combination index values for chemotherapeutic drug/Herceptin? combinations in vitro;Herceptin与每周paclitaxel (n=95);Herceptin 联合 docetaxel Phase II trials ;Herceptin 与 vinorelbine联合;Herceptin与 gemcitabine联合;Herceptin与 docetaxel和platinum 联合（First-line） ;Herceptin与 Xeloda联合;M77001: trial design;M77001: efficacy summary;Herceptin in metastatic breast cancer;3药联合治疗 Her2 Overexpress MBC Weekly VS 3weekly---NCCTG;Response to Therapy(Interim Analysis);Survival(Interim Analysis);Adverse Events: Hematologic(70 Evaluable Patients);Adverse Events: Non-Hematologic(70 Evaluable Patients);Conclusions;Forbes JF, et al. ASCO 2006.