《进展期胃癌个体化药物治疗》ppt课件.ppt

* * * * * * Eligibility criteria for the ToGA trial include: 18 years of age, HER2-positive histologically confirmed gastric cancer or gastro-oesophageal adenocarcinoma, with inoperable, locally advanced or recurrent and/or metastatic disease. The ToGA trial planned to recruit 584 patients. An additional 10 patients, who had already signed the informed consent form when the screening cut-off was reached, were allowed to enter the trial, resulting in a total of 594 patients recruited. The primary end point is overall survival in the two treatment arms. Secondary end points include progression-free survival, overall response rate, clinical benefit rate, duration of response and safety profile. * * * vascular endothelial cell * * In patients with rash of grade 0/1 or grade 2/3, mOS is 7.770m vs 17.570m respectively (p=0.005). Survival in patients with TGF-α≥25ng/L is better than that of patients with TGF-α25ng/L mOS: 12.867m vs 7.767m,P=0.074）. Polymorphism of EGF A61G tends to be related with TTP and OS (G/G type vs G/A type mOS: 13.300 vs 8.933m, P=0.059). Multivariate analysis shows grade of rash and polymorphism of EGFA61G are independent prognostic factors of survival * * Acknowledge my colleague 进展期胃癌个体化药物治疗——药物优化与个体化探索 北京大学肿瘤医院 消化肿瘤内科 目前胃癌化疗药物 氟脲嘧啶类包括口服药:5-FU, capecitabine, S-1 紫杉醇类:紫杉醇、多稀紫杉醇。 铂类:DDP、OXA(oxaliplatin) 蒽环类:EPI 拓扑异构酶I抑制剂:Irinotecan(CPT-11), HCPT 靶向治疗药物: Herceptin,AVASTIN, C225, ….. Randomized Phase III Study In First Line For AGC Study Regimen N RR (%) p OS p V325 2006 DCF CF 103 105 38.7 23.2 .012 10.2m 8.5m .0064 Kang Y 2006 XP FP 160 156 41 29 0.03 10.5m 9.3 m 0.27 S. Al-Batran 2006 FLO FP 98 102 34 27 0.012 5.7(TTP) 3.8 0.081 Wasaburo 2008 S-1+PDD S-1 145 150 54 31 .002 13.0m 11.0 m .04 J Ajani 5FU+PDD S-1+PDD 508 521 24.2 22.5 NS 7.9m 8.6m NS Cunningham 2008 ECF ECX EOF EOX 249 241 235 239 40.7 46.4 42.4 47.9 NS 9.9 m 9.9 m 9.3m 11.2 m NS 胃癌化疗存在的临床问题 三药同时联合高效、高毒!