常见实体瘤化疗方课件.ppt

1、 T1 T2 T3 T4N0N1N2N3M1Lung(Non-Small Cell Carcinomas四组化疗方案对晚期初治四组化疗方案对晚期初治NSCLC患者效果的比较患者效果的比较Kubota,Karmanos CRC(Abstract7106,2000.10-2002.6)DOC 100,1 h q 3 wks,DOC 75 mg/m 1 h q 3 wks最好的支持治疗(BSC)DOC 100 mg/m 1 h q 3 wksDOC 75 mg/m 1 h q 3 wks去甲长春花碱 30 mg/m d1,8,15 q 3 wks,or 异环磷酰胺2 g/m d1,2,3 q 3 w

2、ksRTAX320RTAX317DOC二线治疗二线治疗NSCLCIII期临床试验期临床试验Shepherd F JCO 2000,Fossella JCO 2000Shepherd F JCO 2000,Fossella JCO 2000DOC二线治疗二线治疗NSCLCIII期临床试验期临床试验生存分布函数生存分布函数月月HR=HR=风险比风险比CI =CI =可信区间可信区间MST=MST=中位生存时间中位生存时间0.000.250.500.751.000.02.55.07.510.012.515.017.520.0中位生存时间中位生存时间8.3月月一年总体生存率一年总体生存率:29.7%H

3、R 0.99 95%CI of HR(0.82,1.20)中位生存时间中位生存时间 7.9 月月一年总体生存率一年总体生存率:29.7%ALIMTA(n=280)多烯紫杉醇多烯紫杉醇(n=288)ASCO 2003,JCO Vol 22:1589,20041Tarceva product information;2OSI and Roche data on file3Pemetrexed product information;4Hanna N,et al.J Clin Oncol 2004;22:1589975Docetaxel product information1 Bezjak A,e

4、t al.J Clin Oncol 2006;24:38317;2Dancey J,et al.Lung Cancer 2004;43:18394;3Hanna N,et al.J Clin Oncol 2004;22:158997Fukuoka M,et al.J Clin Oncol 2003;21:223746Kris M,et al.JAMA 2003;290:214958*Assessed using FACT-L questionnaire NR=not reportedFukuoka M,et al.J Clin Oncol 2003;21:223746Recommended d

5、ose for phase III=250mg/dayThatcher N,et al.Lancet 2005;366:152737*No significant difference versus BSC for docetaxel 75mg/m2Comparable symptom control data to docetaxel 75mg/m2 Significant for cough,pain,dyspnoea,global QoL,physical function,emotional function药物药物 生存期生存期改善改善 症状控制症状控制/生活质量生活质量 毒性毒性

6、Docetaxel +Pemetrexed +Tarceva *+CRCResectability AssessmentPrimarilyResectablePrimarilyUnresectableNeoadjuvantSurgery ChemotherapyAdjuvant CTLocalAdjuvantMetastasesOther MeasurementsRT+CT0,50,60,70,80,9101020304050ProbabilityDFS(months)24%risk reduction for stage III patients in the FOLFOX arm FOLF

7、OX(n=672)71.8%LV5FU2(n=675)65.5%3-year5-FU bolus400 mg/m2 over 2-4 min5-FU bolus400 mg/m2 over 2-4 min5-FU infusion600 mg/m2LV 200 mg/m2Oxaliplatin 85 mg/m25-FU infusion600 mg/m2LV 200 mg/m22 h22 h2 h22 hFOLFOX4q2w5-FU bolus400 mg/m2 over 2-4 min5-FU infusion1200 mg/m2/day x 2 daysLV 400 mg/m2Oxalip

8、latin 100 mg/m22 h46-48 hFOLFOX6q2w5-FU infusion1200 mg/m2/day x 2 daysLV 400 mg/m2Oxaliplatin 130 mg/m22 h46-48 hFOLFOX7q2wChemo-nave Dukes C,resection 8 weeks Xeloda1 250mg/m2 twice daily,d114,q21d n=1 004Bolus 5-FU/LV5-FU 425mg/m2 plus LV 20mg/m2,d15,q28dn=983Recruitment1998200124 weeksEstimated

9、probabilityAbsolute difference at 3 years:3.6%1.00.80.60.40123456YearsHR=0.86(95%CI:0.740.99)p=0.0407 3-yearXeloda(n=1 004)65.5%5-FU/LV(n=983)61.9%Cassidy J et al.Proc Am Soc Clin Oncol Late-breaking Abstract Book 2004;23:14(Abst 3509)Estimated probability0123456YearsAbsolute difference at 3 years:3

10、.7%1.00.80.60.4 3-yearXeloda(n=1 004)81.3%5-FU/LV(n=983)77.6%HR=0.84(95%CI:0.691.01)p=0.0706 Cassidy J et al.Proc Am Soc Clin Oncol Late-breaking Abstract Book 2004;23:14(Abst 3509)感谢亲观看此幻灯片，此课件部分内容来源于网络，感谢亲观看此幻灯片，此课件部分内容来源于网络，如有侵权请及时联系我们删除，谢谢配合！如有侵权请及时联系我们删除，谢谢配合！感谢亲观看此幻灯片，此课件部分内容来源于网络，感谢亲观看此幻灯片，此课件部分内容来源于网络，如有侵权请及时联系我们删除，谢谢配合！如有侵权请及时联系我们删除，谢谢配合！