方红明肿瘤个体化靶向治疗的现状与进展.ppt

* * BSC, best supportive care; CI, confidence interval; HR, hazard ratio; NS, not significant; PFS, progression-free survival. ? The event-free survival in patients with mutant KRAS was no different whether patients received panitumumab or not. By contrast, survival results in patients with wild-type KRAS clearly showed benefit from panitumumab. ? One caveat is that because this was not a blinded study, patients receiving best supportive care were likely to be checked earlier in their disease course than those receiving panitumumab and, therefore, were more likely to switch to another therapy. But even with this minor bias in the first 8-week time frame, the KRAS wild-type patients clearly benefited from panitumumab. * * There are many downstream targets of RAS, including BRAF. Some data suggest that patients with mutant BRAF in the presence of wild-type KRAS will not benefit from anti-EGFR antibodies. * * EGFR, epidermal growth factor receptor;?PR, partial response. ? Di Nicolantonio and colleagues conducted a study of anti-EGFR antibodies in 79 patients with wild-type KRAS. Results showed no responses among the 11 patients with mutated BRAF and wild-type KRAS. By comparison, responses were seen in one third of patients with both wild-type BRAF and wild-type KRAS. * 结直肠癌:念题目 EGFR靶向药物：西妥西单抗 结直肠癌:念题目 * * * EGFR, epidermal growth factor receptor; mAbs, monoclonal antibodies; ?? The potential relationship between genetic markers and response is important. Approximately 40% of patients with colorectal cancer have mutated KRAS and will not respond to anti-EGFR antibodies. Within the subset of patients with wild-type KRAS, some will respond to standard dose, some may respond to increased dose, and some will not respond, perhaps due to a BRAF mutation. Identification of these subsets of subsets is important to determine who is likely to benefit and who is not. ? * S?rlie et al. Proc Natl Acad Sci U S A. 2003;100:8418. * * 治疗 (Panitumumab/Cetuximab) 患者数 (野生型: