Lapatinib minimally effective for non-small-cell lung cancer& }0 K) _. e3 d
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NEW YORK (Reuters Health) - Although well tolerated, lapatinib is minimally effective as monotherapy for advanced or metastatic non-small-cell lung cancer (NSCLC), according to a report in the March 15th Clinical Cancer Research.5 F1 v$ H8 k4 i2 ] _9 E" C" u+ P
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Lapatinib (GlaxoSmithKline) is a tyrosine kinase inhibitor of both epidermal growth factor receptor (EGFR) and HER2, the authors explain, and thus has theoretical advantages over inhibition of either EGFR or HER2 alone. 0 Y% w5 u4 X1 n, [' [
" ^3 _: p. m2 z. G% x* Y, Q* CDr. Helen J. Ross, from Mayo Clinic, Scottsdale, Arizona, and colleagues evaluated the overall response rate to lapatinib in 131 patients with advanced or metastatic NSCLC. Sixty-five patients were randomized to lapatinib 1500 mg once daily and 66 to lapatinib 500 mg twice daily.
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When the study began, patients with any type of advanced or metastatic NSCLC were recruited ("non-targeted" population). However, when data from other studies began to show that EGFR inhibitors are particularly effective in patients with bronchioloalveolar carcinoma and in never-smokers with any histology of NSCLC, recruitment began to "target" such patients.
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The targeted population included 24 patients in the 1500 mg/day group and 32 in the 500 mg twice daily group. The corresponding numbers in the non-targeted population were 41 and 34.
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At the interim analysis of the first 30 targeted patients to reach the initial response evaluation, the response rate was 0% in both treatment groups. In the non-targeted population, one patient in the 1500-mg group achieved a partial response.
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Overall, 31 of 131 patients (24%) had stable disease or better.
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Based on these findings, the study was stopped for reasons of futility, the investigators state.
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Overall survival in the targeted population was 15.2 months for the 1500-mg once-daily group and 13.9 months for the 500-mg twice-daily group, and in the nontargeted population, overall survival was 11.4 months for the 1500-mg once-daily group and 8.1 months for the 500-mg twice-daily group. 1 _0 F$ u9 _9 X; I
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Median progression-free survival was 15.6 weeks (1500-mg once-daily) and 8.7 weeks (500-mg twice-daily) in the targeted population and 12.0 weeks (1500-mg once-daily) and 8.6 weeks (500-mg twice-daily) in the nontargeted population. c2 `: c: {& e0 }$ X
; t4 z7 S/ x: d8 c; k" DThe incidence of adverse events considered to be related to study medication was 89% for 1500 mg once daily and 83% for 500 mg twice daily, but only 8% of patients in each group experienced serious adverse events related to study medication. ' X6 n6 N+ I' \2 \. r8 |
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Among 92 patients with tumor tissue available, 2 had mutations in EGFR and 1 had mutations in both EGFR and KRAS. None had mutations in HER2.
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8 E: G2 H4 p; _7 [Of 77 patients with sufficient DNA for gene copy evaluation, 5 (8.8%) had increased EGFR copy number and 2 (3.5%) had increased HER2 gene copy number. + S5 X, E% ~4 `, Y' n
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None of the patients with EGFR mutations responded to lapatinib, and only 1 patient with HER2 amplification had an unconfirmed decrease of 51% in tumor measurement.
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"Lapatinib as a single agent at the doses studied seems to have minimal single-agent activity, at least as measured by response rates," the authors conclude, "although progression-free survival in the 1500-mg once-daily group was in the range that would be expected with first-line chemotherapy." - I$ D$ c/ _; J( h- ~5 y( b
' ^( o! ^, @; {+ y4 I% i- F# |"Patients in this small study had a suggestion of disease stabilization with lapatinib," Dr. Ross said. "It would be of interest to examine it in the adjuvant setting after resection perhaps, after chemoradiotherapy perhaps or after up-front chemotherapy. It is possible that combination with other targeted agents, such as anti-angiogenic agents, might be useful."
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The study was sponsored by GlaxoSmithKline.
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晚期肺癌经过4次换药，如今母亲已经4
作者：pears
“万事开头难”这句话在母亲的抗癌路上体现得淋漓尽致，最初确诊肺癌后半
都说免疫不入脑，入了就不得了
免疫治疗以后的疗效反应，当病灶增大时，不一定是进展，还有一种可能，叫做CR，这个现
母亲的基因检测和PD-L1报告出来了，
看了基因检测报告，似乎没有合适的靶向药，母亲确诊肺腺癌晚期，求助大家帮忙分析一下
头部长个包 免疫性副反应吗
我们已经治疗将近四年了 一直用的单免疫治疗 没有用其他治疗 之前用的信迪利 今年初
既要，又要，还要，什么药品可以治疗
作者：seacat
EGFR突变可以分为常见突变和罕见突变。常见突变就是EGFR外显子19del突变
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显身卡
