本帖最后由 草船借箭 于 2014-7-15 10:41 编辑 3 Y. N0 f8 o4 n! n9 d0 \1 g; B. S http://www.18222788817.com/kangairiji/2013/24.html" h6 l' J \3 m: Y# b% y 易瑞沙如何减量服用？/ w7 ]& g5 E' A# k6 l" _
/ O$ J, L/ n( z( u2 H http://blog.sina.com.cn/s/blog_66cd4ad301010vht.html : j2 Z; B: ?0 yEGFR突变的晚期NSCLC患者，低剂量吉非替尼疗效不劣于常规剂量 7 b. l4 M* E. N2 r
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肺腺-属-Y-易 10:09:57 6 A% ^" j' X- ^; ~
易的达峰时间是3-7小时，就算平均5小时达到药峰浓度 9 ~. ]5 N! V0 H4 E8 w7 \肺腺-属-Y-易 10:10:33 0 H& c% h, k5 `$ c消除从5小时后开始 - j2 F( _3 O0 C6 C& I* q. @( w( D0 L; d2 ]" d' U( l( Q, {1 S! s
肺腺-属-Y-易 10:26:56 , S. H/ J O; ?7 l# k- B
有几个关于低剂量的易的临床是使用隔天一片的方案 % Y/ }- ^( `, T) l3 D$ z2 x" H- ]肺腺-属-Y-易 10:27:10 / u" a! T+ |( R. D! N% BNEJ0029 u$ z( u2 j9 |+ w0 G# y: n- K
8 V1 M! _! n, }0 ]- }8 L. |肺腺-属-Y-易 10:29:34 : K+ i8 a& d, q$ i, \4 P( V+ c4 e/ [
你百度＂NEJ002 低剂量＂$ ? t2 r& A6 D! s# z7 U
肺腺-属-Y-易 10:29:43 . S G0 l6 u4 e& Z( W第一个链接就是 % o8 W6 r, n0 S! h : ]) ]7 O( S# U3 Q肺腺-属-Y-易 10:29:58 2 ]* B9 G. t, E6 \7 K但是没写低剂量方案3 c: v6 ^% g3 e9 o8 Q& h% z: Q
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草船借箭 10:31:31 ( C# |% W) M( s! I; G没写隔天服用还是减量每天服用 N, y$ P, f$ u! L肺腺-属-Y-易 10:32:31 - v3 U+ a4 K6 D, H* FASCO摘要里面写的是＂大多数患者换成每两天一次的给药方案＂3 d3 J, g0 J. C. Z
肺腺-属-Y-易 10:32:50 6 i a; ?$ J3 M8 J: ~4 Z
every-2 day schedule8 b" |- V+ w) e# H
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肺腺-属-Y-易 10:34:40 $ s. `# Z- d( ~; F6 S' X, [: G
2011年11月发表在JTO上面一片研究低剂量易对晚期患者疗效的论文! V" ^( b6 [) u Z9 C3 X
' z8 j0 M) t2 h0 e! d. f' W肺腺-属-Y-易 10:35:48& `2 W) K6 d+ `0 a, L
里面也采用了NEJ002的方案隔天一片( r4 J' x, ?4 j* v
changing the everyday schedule to every 2 days schedule( ^+ T& o' c( I7 _2 d
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肺腺-属-Y-易 10:40:295 u1 z Y6 g6 L9 X. ~6 J
临床设计看起来偏向于隔天一片; W# L+ C; a. e3 M, r9 {) x
草船借箭 发表于 2014-7-15 10:04$ z y- H1 k1 Q- C. N5 J
http://www.18222788817.com/kangairiji/2013/24.html* R- [: ]9 U, q& i, m5 X
易瑞沙如何减量服用？
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The efficacy of low-dose gefitinib for advanced non-small cell lung cancer (NSCLC) with sensitive epidermal growth factor receptor (EGFR) mutations: A post-hoc analysis from NEJ002. / g/ b: ?5 `6 Z- `: ~, n. F( f# T% N Abstract: ( z$ N( w n4 B6 x; b" X & g- i7 Y) J" M' l; y8 T3 ]) EBackground: NEJ002, a phase III trial comparing gefitinib with carboplatin-paclitaxel as the first-line treatment for advanced NSCLC with sensitive EGFR mutations, showed a significant improvement in progression-free survival (PFS) in the gefitinib arm. Although standard schedule of gefitinib was the administration of 250 mg tablet every day, more than half of patients in the gefitinib arm reduced the dose of gefitinib mainly because of toxicities. However, the efficacy of such low-dose (LD) gefitinib has rarely been evaluated. ( J0 S, v/ w% h3 X( I2 ~4 A- W/ ^8 u4 l! O/ c Methods: A post-hoc analysis of the efficacy (response rate and survival) in patients who took gefitinib without any dose reduction during their treatment period and those in patients who received LD gefitinib at any point during the treatment period was performed. * j( F& i' V7 ] , x- P3 `4 X; J% |, D' a P3 V( J% aResults: Among 114 patients of the first-line gefitinib group in NEJ002, 52 (46%) continued gefitinib without break until their diseases progressed (categorize as group A), and 62 (54%) was reduced their dose of gefitinib (most of them moved into every-2-days schedule) because of some toxicities (same as group B). There was no significant difference of patient characteristics between two groups. Interestingly, PFS of group B seemed to be better than that of group A (median PFS, 301 days in group A versus 351 days in group B; p = 0.450) and overall survival was also similar between the groups (median survival time, 852 days versus 928 days, respectively; p = 0.674). 0 c8 j) h2 R1 d- u7 _: h& ~62名患者减量服用吉非替尼(大多数换成了两天一片的用药方案) * j" E% Q) d3 U; v" ]* L; D( @9 Y2 [7 w/ P, n2 `) x! ~, z Conclusions: The results suggest that LD gefitinib may be clinically not inferior to standard schedule of gefitinib for NSCLC with sensitive EGFR mutations. Considering the merit in terms of risk-benefit balance, prospective study of LD gefitinib is warranted.$ k: p p4 A" z+ {1 J4 g3 f6 y
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