我父亲肺鳞癌的治疗贴(2014年3月1日驾鹤西去）

老马 · 发表于 2012-4-26 22:27:08

本帖最后由老马于 2012-4-26 22:36 编辑

4月20日：美国华盛顿大学医学院Govindan等人报告一项多中心Ⅱ期临床研究称：对于化疗过的非亚裔晚期NSCLC患者，使用S-1单药的耐受性良好，而且疗效可与其他已批准的药物想媲美。该报告发表在2011年2月15日的《JThoracOncol》在线版上。
　　S1是一种新型的口服氟脲嘧啶制剂，在日本NSCLC患者中已显示有一定疗效，且耐药性良好。研究人员从美国21个中心入组了57例晚期NSCLC患者，都是只接受过一次化疗。对所有患者予S-1(30mg/m2，q12h，连续14天后休息7天)化疗，直至符合停药标准为止。主要的研究终点为客观缓解率。
　　根据独立评估结果，研究结果如下：客观缓解率和疾病稳定率分别是7.1%和48.2%，疾病控制率为55.3%。无进展生存期2.9个月，中位总生存 7.3个月，1年的生存率为31.6%。各组织学亚型患者生存期没有明显的差异。患者对S-1的耐受性良好，最常见的因治疗引起的不良反应有恶心 (54%)和腹泻(49%)。

氟尿嘧啶类药物的疗效预测标志物的研究进展.pdf (876.72 KB, 下载次数: 99)

老马 · 发表于 2012-4-27 15:58:09

本帖最后由老马于 2012-4-27 18:25 编辑

今天上单药泰素帝。
今天出了淋巴免疫组化结果：CD3+81.1%，正常,CD8+53.2%偏高（正常值范围18.5%-42.1%）,CD4+27.2正常（正常值范围24.5%-48.8%），比2月时做的检查值改善了不少。
心肌五酶正常。明天做心超。

英雄武松 · 发表于 2012-4-27 16:07:52

祝福单药泰素帝疗效显著！

老马 · 发表于 2012-4-27 18:50:42

Pooled Analysis of S-1 Trials in Non-Small Cell Lung Cancer According to Histological Type
NOBUYUKI YAMAMOTO1, TAKEHARU YAMANAKA2, YUKITO ICHINOSE3, KAORU KUBOTA4, HIROSHI SAKAI5, AKIHIKO GEMMA6, NAGAHIRO SAIJO7, MASAHIRO FUKUOKA8 and HISANOBU NIITANI9
+ Author Affiliations

1Division of Thoracic Oncology, Shizuoka Cancer Center, Shizuoka 411-8777, Japan
2Cancer Biostatistics Laboratory, Institute for Clinical Research, National Kyushu Cancer Center, Fukuoka 811-1395, Japan
3Department of Thoracic Oncology, National Kyushu Cancer Center, Fukuoka 811-1395, Japan
4Division of Thoracic Oncology, National Cancer Center Hospital, Tokyo 104-0045, Japan
5Division of Thoracic Oncology, Saitama Cancer Center, Saitama 362-0806, Japan
6Division of Pulmonary Medicine, Infectious Diseases, and Oncology Department of Internal Medicine, Nippon Medical School, Tokyo 113-8603, Japan
7Kinki University School of Medicine, Osaka 589-8511, Japan
8Izumi Municipal Hospital, Osaka 594-0071, Japan
9Tokyo Cooperative Oncology Group, Tokyo 105-0013, Japan
Correspondence to: Nobuyuki Yamamoto, Division of Thoracic Oncology, Shizuoka Cancer Center, 1007 Shimonagakubo, Nagaizumi-cho, Sunto-gun, Shizuoka 411-8777, Japan. Tel: +81 559895222, Fax: +81 559895783, e-mail: n.yamamoto@scchr.jp
AbstractBackground: The antimetabolic agent S-1 inhibits thymidylate synthase similar to pemetrexed, but through a different mechanism of action. Whether the antitumour activity of S-1 depends on histological type remains unclear. We analysed pooled data from 2 phase II clinical studies of cisplatin and S-1 in patients with previously untreated advanced non-small cell lung cancer. Patients and Methods: We comprised 110 patients with stage IIIB or IV non–small cell lung cancer. Univariate and multivariate analyses were performed to determine the effects of histological type on progression-free survival and response rates. Results: On pooled analysis of the data, according to histological type, median progression-free survival was 3.8 months in patients with squamous cell carcinoma and 4.4 months in those with non-squamous cell carcinoma. Both analyses showed that progression-free survival and response rate did not differ significantly. Conclusion: Unlike molecular targeted agents and pemetrexed, a combination of cisplatin and S-1 may be no difference in response according to histological type.

老马 · 发表于 2012-4-27 18:52:43

S-1 monotherapy for previously treated non-small cell lung cancer: A retrospective analysis by age and histopathological type

Authors: Yuki Tomita, Tetsuya Oguri, Osamu Takakuwa, Makoto Nakao, Eiji Kunii, Takehiro Uemura, Hiroaki Ozasa, Mikinori Miyazaki, Ken Maeno, Shigeki Sato

Affiliations: Department of Medical Oncology and Immunology, Nagoya City University Graduate School of Medical Sciences, Mizuho-cho, Mizuho-ku, Nagoya, Aichi 467-8601, Japan

Published online on: Thursday, December 1, 2011

Doi: 10.3892/ol.2011.507

Pages: 405-410

Abstract:
S-1, an oral fluoropyrimidine derivative, has been approved for the treatment of non-small cell lung cancer (NSCLC) in Japan. In the present study, the efficacy and safety of S-1 monotherapy for elderly patients with previously treated NSCLC were retrospectively evaluated, and the efficacy of S-1 monotherapy was compared by histopathological type. This retrospective study included 54 patients with advanced or recurrent NSCLC who had received S-1 monotherapy following the failure of previous chemotherapy regimens at our institutes. Patient outcomes were compared based on their age and histopathological type. S-1 was administered orally, twice daily, while the duration and interval were modified according to the medical condition of each patient. The default delivery schedule, the mean number of S-1 cycles, did not differ significantly between the two age groups (<70 and ≥70 years). The rate of therapy discontinuation, schedule modification or dose reduction due to intolerable toxicities or patient refusal was relatively frequent in the older group (40.7 and 55.6% for ages <70 and ≥70 years, respectively; p=0.414), and the incidence of grade 3 anemia was relatively high in the older group (3.7 and 18.5%, respectively; p=0.192). The response rates (13.0 and 4.8%, respectively; p=0.609) and disease control rates (39.1 and 33.3%, respectively; p=0.761) did not differ significantly between the two age groups. According to histopathological type, the disease control rate was significantly higher in adenocarcinoma (57.9%) compared to non-adenocarcinoma (20.0%, p=0.013). Thus, S-1 monotherapy may be equally effective and tolerated in patients <70 years and those ≥70 years. Additionally, adenocarcinoma may have a higher disease control rate than non-adenocarcinoma.

老马 · 发表于 2012-4-27 18:57:27

Thymidylate synthase (TS) gene expression in primary lung cancer patients: a large-scale study in Japanese population
F. Tanaka1,*, H. Wada2, Y. Fukui3 and M. Fukushima3
+ Author Affiliations
1Second Department of Surgery, University of Environmental and Occupational Health, Kitakakyushu
2Department of Thoracic Surgery, Kyoto University, Kyoto
3Tokushima Research Center, Taiho Pharmaceutical Co. Ltd, Tokushima, Japan
↵*Correspondence to: Dr F. Tanaka, Second Department of Surgery, University of Environmental and Occupational Health, 1-1 Isegaoka, Yahata-nishi, Kitakakyushu, 807-8555, Japan. Tel: +81-93-891-7442; Fax: +81-93-692-4004; E-mail: ftanaka@med.uoeh-u.ac.jp
Received September 3, 2010.
Revision received November 11, 2010.
Accepted November 17, 2010.
Abstract
Background: Previous small-sized studies showed lower thymidylate synthase (TS) expression in adenocarcinoma of the lung, which may explain higher antitumor activity of TS-inhibiting agents such as pemetrexed.
Patients and methods: To quantitatively measure TS gene expression in a large-scale Japanese population (n = 2621) with primary lung cancer, laser-captured microdissected sections were cut from primary tumors, surrounding normal lung tissues and involved nodes.
Results: TS gene expression level in primary tumor was significantly higher than that in normal lung tissue (mean TS/β-actin, 3.4 and 1.0, respectively; P < 0.01), and TS gene expression level was further higher in involved node (mean TS/β-actin, 7.7; P < 0.01). Analyses of TS gene expression levels in primary tumor according to histologic cell type revealed that small-cell carcinoma showed highest TS expression (mean TS/β-actin, 13.8) and that squamous cell carcinoma showed higher TS expression as compared with adenocarcinoma (mean TS/β-actin, 4.3 and 2.3, respectively; P < 0.01); TS gene expression was significantly increased along with a decrease in the grade of tumor cell differentiation. There was no significant difference in TS gene expression according to any other patient characteristics including tumor progression.
Conclusion: Lower TS expression in adenocarcinoma of the lung was confirmed in a large-scale study.