胰腺癌靶向治疗进展.pptVIP

近年来随着各种诊疗技术的进步,癌症的治愈率和生存率较以往有了较大的改善,可是,有一种肿瘤仍被冠以“早期诊断率低、预后极差、远期生存率最低、在所有肿瘤中治愈率最低……”,它就是——胰腺癌。MooreMJetal.JClinOncol2007;25:1960-6GV1001telomerasepeptidevaccinec-kit指干细胞因子受体；FAK指黏着斑激酶；FGFR指成纤维细胞生长因子受体；IGF-IR指I型胰岛素样生长因子受体；MEK指有丝分裂原活化的蛋白激酶—细胞外信号—调节激酶，PDGFR指血小板源生长因子；PSCA指前列腺干细胞抗原；SPARC指富含半胱氨酸的酸性分泌蛋白；TNF-α指肿瘤坏死因子α。试验组(卡培他滨+厄洛替尼健择?)的TTF2与对照组相近(健择?+厄洛替尼卡培他滨)C,adeathreceptor5agonist,andA,aninsulin-likegrowthfactorreceptor1antagonist,areinvestigational,fullyhumanmonoclonalantibodieswithpreclinicalactivityinPCmodels.Weconducteda3-arm,placebo-controlled,randomizedphaseIIstudyevaluatingbothagentsinmPCpts.Methods:EligibleptshadnopriortherapyformPC;PS0-1;nopoorlycontrolleddiabetes.Primaryendpoint:6-month(mo)overallsurvival(OS).ThestudywasdesignedtoestimatetheefficacyofaddingCorAtoG;120ptsprovides80%powertodetectadifferencebetweena6-moOSof45%forPand69%forCorA.Stratification:PS(0vs.1).Ptswererandomlyallocated1:1:1toArm1:C+G(double-blinded);Arm2:A+G(open-labelduetoanticipatedthrombocytopeniaandhyperglycemia);Arm3:P+G(double-blinded).PtsreceivedC10mg/kg,orA12mg/kg,orPintravenously(IV)days(D)1and15andG1000mg/m2IVover30minutesD1,8,15Q28D.CTscans:Q2cycles.Results:125pts(Arms1/2/3:41/42/42pts)at37centersenrolled3/08-4/09;41/40/40received≥1doseofstudydrug.Medianage61/66/61years;male59/60/62%;PS159/55/62%;livermetastases66/71/79%.Deathstodate68/48/57%.Efficacyisshowninthetable.Grade3/4adverseevents(%pts,Arms1/2/3):neutropenia22/18/13%;thrombocytopenia15/15/8%;fatigue12/10/5%;hyperglycemia2/15/3%.Nopost-doseanti-Cnoranti-Aantibodiesweredetected.Conclusions:TheadditionofCorAtoGiswell-toleratedandresultsintrendstowardlongerPFS,improved6-moOS,andhigherratesofstabledisease,whencomparedwithG