个体化精准治疗济南简.ppt

胰腺癌: 内科治疗之悲惨世界FDA Approved Protocle: Moore et al 放射免疫治疗:远隔效应 Thanks for Your Kind Attention! 精准肿瘤学挑战 Challenge: Presicion Medicine 检测方法不精确带来的治疗不精确 监测不到靶点或监测到也无药可用 也将和循证及转化医学一样被淡化 精准医学一定不是唯一版和终极版 肿瘤的病因仍是未知的和多因素的 是不断发展完善:3DCRT;IMRT;IGRT 解决老的价格贵又带来新价格毒性 从群体到个体精确又带来药价飙升 1.When a distinguished scientist states that something is possible, he is almost certainly right. When he states that something is impossible, he is very probably wrong 2.The only way of discovering the limits of the possible is to venture a little way past them into the impossible 3.Any sufficiently advanced technology is indistinguishable from magic 创新:精准治疗皆有可能 要在精准医学指导下 实施个体化精准治疗 成也规范 败也规范 成也指南 败也指南 战略科学家引领 集成创新与突破 Precision Medicin & Innovation * * Overall survival (OS) was calculated in months from the day of randomization to the date of death. Otherwise, OS was censored at the last day the patient was known to be alive. Of the 569 patients accrued in this trial, 485 had died (238 on the TarcevaTM arm and 247 on the placebo arm) at the data cut-off date. Based on a stratified log-rank test adjusted for performance status and extent of disease at randomization, median OS was significantly longer in the TarcevaTM (6.37 months) than the placebo arm (5.91 months). The hazard ratio (HR) was 0.79 (95% CI 0.66-0.95; P=0.011) (ie patients treated with TarcevaTM had a 21% better chance of survival than those receiving placebo). These data are based on patients receiving TarcevaTM at 100 and 150 mg/day please note that the HR in the NCIC analysis is 0.81 (95% CI 0.67-0.96; P=0.025). HR should be considered the overall measure of benefit, as it reflects the survival trend for the group over the whole duration of the trial. Using median survival only can be misleading as it gives survival at a single point, which may be subject to abnormalities. In this trial the curves actually converge at the median point. One-year survival was 24% in the TarcevaTM arm compared with