抗血管生成治疗晚期NSCLC的策略演进.pptVIP

抗血管生成治疗总结 贝伐珠单抗是第一个临床应用的抗血管生成药物；能给患者带来PFS和OS的生存获益；并且在老年患者，脑转移患者也显示出良好的安全性，经过合理的患者选择，约80%的非鳞癌患者都可以接受贝伐治疗。 其他的抗血管生成药物目前尚未证实有明确疗效，如VEGF-Trap、索拉菲尼等，虽然ORR或PFS有一定获益，但是OS不令人满意，因此均未获得上市应用批准。 2012ASCO 抗血管生成领域主要探索方向：特殊人群的用药（如老年患者）；新的用药方式（如贝伐胸腔内灌注）；用药持续时间的探讨（贝伐持续用药，AvaALL）等。 谢 谢 ！ 血管通透性因子（vascular permeability factor,VPF） * IMC-IC11是一种正在研发的新药，只查到代号 参考文献1-贝伐作用机制 * Results: NSCLC enrollment completed 06/2009. As of 09/2009, 1,970 pts had median follow-up of 9.6 mo. The IRF reviewed BL scans of 1,881 pts; 1,470 (78%) had 1 BL measurable (meas) tumor ( 0.5cm) and 49% (718) were central; 67% had largest tumor size 3 cm; 14% had cavities and 10% had 1 cavity. BL tumor characteristics were generally similar across subpopulations (age 70, PS 2, pts with CNS mets). Pts with a history (Hx) of hemoptysis (n = 105) had more centrally located tumors, fewer numbers of meas tumor, and larger cavity size. There are 15 (0.8%) reported SPH events to date; 2 pts had no BL CT scan submitted and 2 pts with BL scans had no meas tumor (1 had Hx of hemoptysis). Of the remaining 11 pts with SPH: 8 had central tumors; 1 had cavitation (1.2 cm); 0 were on anticoagulants at BL; largest tumor size ranged from 1.8-11.6cm. There was 1 SPH in pts with 1 cavity (0.5%) and 8 in pts with central tumors (1.1%). * 参考文献8-2011肺出血共识-Ann Oncol-2011 Thoracic computed tomography images that show no clear vessel invasion by non-small-cell lung tumours. (A) Central tumour with infiltration of main carina and both main bronchi but no evident infiltration of large central blood vessels; (B) Central tumour with direct infiltration of the mediastinum but no clear infiltration of central blood vessels; (C) Central tumour touching without sign of pulmonary artery infiltration. The presence of an atelectasis makes the interpretation difficult and may necessitate multiplanar reconstructions to aid decision making. 咯血史的患者的出血风险较高，来自ARIES研究的数据 * 参考文献9-Sail Elderly-JTO-2012 * 参考文献9-Sail Elderly-JTO-2012 * 参考文献11-脑转移发生概况-JT