抗血管生成的在NSCLC的应用.ppt

What is the optimal clinical applications of anti-angiogenic-based NSCLC strategies to help more patients in the maintenance and second-line setting???John Heymach, MD, PhDAssociate ProfessorThoracic/Head and Neck Medical Oncology and Cancer BiologyFourth Annual Symposium on Personalized Therapies and Best Clinical Practices for Lung CancerLos Angeles, CASeptember 17, 2011 DisclosuresAdvisory boards for Genentech and AstraZenecaResearch support from AstraZeneca Case #156 yo woman with 15 pack-year history presents with a malignant pleural effusion, mediatinal adenopathy, and a 3-4 small CNS metastases. She has been having mild headaches recently. Cytology reveals adenocarcinoma, TTF1+EGFR mutatation testing could not be performed from cell block and additional biopsy refused. She is initially treated with stereotactic XRT for her CNS lesions and comes for systemic therapy. Which chemotherapy regimen is not supported by randomized phase III data? Carbo/pacCarbo/pac/BVPem/cisPem/carbo/BVQuestion 1 Question #1She is initially treated with stereotactic XRT for her CNS lesions and comes for systemic therapy. Which chemotherapy regimen is not supported by randomized phase III data? Carbo/pacCarbo/pac/BVPem/cisPem/carbo/BV Case #1She is started on treatment with carboplatin, paclitaxel, and BV x 6 cycles. She has a partial response, tolerates treatment well, and wants to be treated aggressively. Which maintenance therapy is part of a regimen that has been shown to prolong OS in a randomized phase III study?BV monotherapyPemetrexedBV+PemBV+erlotinibA and BA, B, and DNo maintenance therapyQuestion 2 Question #2Which maintenance therapy is part of a regimen that has been shown to prolong OS in a randomized phase III study?BV monotherapyPemetrexedBV+PemBV+erlotinibA and BA, B, and DNo maintenance therapy 12 mo. 24 mo. 43.7% 16.9% 51.9% 22.1% 0.00.20.40.60.81.0ProbabilityPCPCB P = 0.007061218243036MonthsMedians: 10.2, 12.5HR: 0.77 (0.65, 0.93)Phase III Trial of