肿瘤分子靶向治疗-王树滨推荐.ppt

EMB .“鸡尾酒”式疗法是发展趋势 * * * * * KRAS 野生型58% KRAS突变型 42% 一 线 治 疗 * 一 线 治 疗 FOLFLOX+CET ≯ FOLFLOX * NCCN Clinical Practice Guidelines in Oncology Colon Cancer v.2008 FOLFOX Irinotecan + Cetuximab FOLFOX or CAPOX + Bevacizumab FOLFIRI + Bevacizumab Single-Agent Irinotecan Irinotecan ? Cetuximab FOLFOX Irinotecan + Cetuximab Irinotecan + Cetuximab Single-Agent Irinotecan FOLFOX 5-FU/LV* + Bevacizumab or or or or Irinotecan + Cetuximab FOLFIRI or FOLFIRI or Single-Agent Irinotecan Intensive Therapy Minimal Therapy First-Line Therapy Second-Line Therapy Third-Line Therapy Fourth-Line Therapy * A treatment option for patients not able to tolerate oxaliplatin or irinotecan. FOLFOX or CAPOX + Cetuximab？ FOLFIRI +Cetuximab？ 5-FU/LV* + Cetuximab？ Will be changed…… * Cetuximab Chimeric IgG-1 against EGFR 30% murine 3%HSR ADCC? Half-life:5day Today’s Issue ③ Molecular Targeted Drugs in Colorectal Cancer Bevacizumab humanized IgG-1 against VEGF Optimal dose under evaluation FDA approved dose 5mg/kg Half-life: 20d+ Panitumumab Fully human IgG-2 against EGFR 1%HSR ADCC: No Half-life: 7.5day * Panitumumab * 手 术 转 移 辅助化疗 一线治疗 二线治疗 三线治疗 Panitumumab: Randomised Trials in Progress Patients with Metastatic Colorectal Cancer BSC Panitumumab vs Trial Peeters ? ? 3rd line 2nd line 1st line Adjuvant * 二 线 治 疗 * 二 线 治 疗 Panitumumab BSC * Cetuximab Chimeric IgG-1 against EGFR 30% murine 3%HSR ADCC? Half-life:5day Today’s Issue ④ Molecular Targeted Drugs in Colorectal Cancer Bevacizumab humanized IgG-1 against VEGF Optimal dose under evaluation FDA approved dose 5mg/kg Half-life: 20d+ Panitumumab Fully human IgG-2 against EGFR 1%HSR ADCC: No Half-life: 7.5day * Panitumumab VEGF + EGFR * 手 术 转 移 辅助化疗 一线治疗 二线治疗 三线治疗 Combination: Randomised Trials in Progress Patients with Metastatic Colorectal Cancer Trial BOND-