上午第二部分肿瘤个体化靶向治疗的现状与进展.ppt

* 谢 谢 ！ * * * 孔子主张“因材施教，发展学生的个性特长 ” * 伏尔泰: 法国启蒙思想家、文学家、哲学家 * * * Reference Lynch TJ et al. N Engl J Med 2004; 350: 2129-2139. * * 临床研究发现，EGFR表达量高的非小细胞肺癌患者接受易瑞沙治疗，无进展生存率明显高于EGFR表达量低的患者 * * EGFR E18/19/21突变接受吉非替尼治疗获益显著 * 而， EGFR E20突变患者对吉非替尼治疗，表现为要耐药 * * * * * * * * * * CRC, colorectal cancer * EGFR, epidermal growth factor receptor. The BOND study showed no correlation between EGFR receptor status and clinical response, as determined by immunohistochemistry. For instance, the data showed that patients given irinotecan plus cetuximab had a consistent response rate of 20% to 25%, regardless of whether they had a low or high percentage of EGFR-expressing cells or a low or strong EGFR staining intensity. In other words, EGFR receptor expression did not help to distinguish and predict for higher or lower toxicity. Other published data also suggest that patients not expressing the EGFR receptor, at least by immunohistochemistry, can respond as well as patients that have a high expression of the receptor. * EGFR, epidermal growth factor receptor; IHC, immunohistochemistry; OS, overall survival. Similarly, in the pivotal study of panitumumab vs best supportive care, there was no difference in activity for panitumumab based on EGFR staining intensity. However, further analysis evaluated whether other factors might predict efficacy. * EGFR, epidermal growth factor receptor; FISH, fluorescence in situ hybridization. Moroni and colleagues published interesting data on the possible role of EGFR gene copy number in the treatment of metastatic colorectal cancer. Indeed, this study and later studies demonstrated a correlation between EGFR copy number and activity of anti-EGFR agents. * CR, complete response; EGFR, epidermal growth factor receptor; PD, progressive disease; PR, partial response; SD, stable disease. Sartore?Bianchi and colleagues conducted a retrospective study in which they looked at the EGFR copy number and outcomes with panitumumab therapy.