课件：肿瘤的靶向治疗.pptVIP

肝转移灶切除 －背景 约 35% 的 CRC 患者在初诊时就发现存在转移病灶 超过80％的患者的肝转移灶最初不能切除 5 年生存率：转移灶不能切除者为 2%，转移灶能切除者为 30% 目前的化疗可使15% 左右的患者得到肝转移的切除 这部分患者可获得显著的生存获益: 5年生存率为 30% 10年生存率为 20% Folprecht et al. Ann Oncol 2005;16:1311-1319 1.化疗+生物靶向治疗效果好 2.应用于晚期结直肠癌的治疗 (mCRC) 特别提醒！！！ 应用EGFR抗体做靶向治疗前须行K-ras检查，野生型患者可以受益，突变型患者效果不明显。60%患者为K-ras野生型。 检测K-ras可以预测疗效，减少费用，避免不良反应及毒性。 什么是KRAS RAS是细胞内信号传导途径中的“下游区”的一种信号传导蛋白，于受体激活后被激活，可以影响细胞的生长，存活和分化等功能。RAS基因与人类肿瘤相关，其中 KRAS最为重要。发生突变的称为突变型，未发生突变的称为野生型。 谢 谢 THANK YOU SUCCESS * * 可编辑 * * - The epidermal growth factor receptor (EGFR) is a transmembrane receptor with an intracellular tyrosine kinase domain, which is activated by growth factors. The main activating ligands are epidermal growth factor (EGF) and transforming growth factor-alpha (TGF-alpha).[1] - EGFR is a proto-oncogene and its activation plays a key role in the development of many cancers.[2] Activation occurs because of gene amplification, gene mutation and/or autocrine stimulation due to the overproduction of the EGFR ligands (e.g. EGF and TGF-alpha). Activation leads to the pairing of receptors with either another EGFR (homodimers) or another member of the EGFR family (heterodimers).[1] - Receptor dimerization initiates an intracellular signaling cascade, gene activation and the stimulation of cell cycle progression.[1] 1. Baselga J. Eur J Cancer 2001; 37 Suppl 4:S16–S22. 2. Yarden Y, Sliwkowski MX. Nat Rev Mol Cell Biol 2001; 2:127–137. * - The EGFR intracellular signaling cascade stimulates cell proliferation, angiogenesis, cell migration and metastasis formation and also provides protection from apoptosis and prevents the loss of differentiation (ie all the key processes involved in tumorigenesis).[1] - EGFR is expressed in a high proportion of solid tumors, in particular head and neck, lung and colorectal cancer.[2] Expression has been correlated with disease progression.[3] Many studies have shown that EGFR expression can be an adverse prognostic factor