非小细胞肺癌脑转治疗方法荟萃（更新于2011年11月9日）

beleon · 发表于 2013-12-21 10:44:05

老马老师您好,
爸爸四期低分化腺癌脑转靶向请教
http://www.yuaigongwu.com/forum. ... 8&fromuid=30155
(出处: 与癌共舞)
服易3个月后,一切指标正常,CEA:4.63;
空窗20天,CEA维持在4.60;
空窗43天CEA上升到5.94;检测医院参考值范围:0-6.5;
是等CEA指标超过6.5再重新服易好,还是现在就该服易?

老马 · 发表于 2014-1-3 11:47:26

Associations between Single Nucleotide Polymorphisms in the PI3K/PTEN/AKT/mTOR Pathway and Increased Risk of Brain Metastasis in Patients with Non-Small-Cell Lung Cancer
http://clincancerres.aacrjournal ... stract.html?papetoc
Purpose:Non-small cell lung cancer (NSCLC) metastasizes fairly often to the brain, but identifying which patients will develop brain metastases (BM) is problematic. The phosphatidylinositol-3 kinase (PI3K)-AKT-mammalian target of rapamycin (mTOR) signaling pathway is important in the control of cell growth, tumorigenesis, and cell invasion. We hypothesized that genotype variants in this pathway could predict BM in patients with NSCLC. Experimental Design:We genotyped 16 single nucleotide polymorphisms (SNPs) in 5 core genes (PIK3CA, PTEN, AKT1, AKT2, and FRAP1) by using DNA from blood samples of 317 patients with NSCLC and evaluated potential associations with the subsequent development of BM, the cumulative incidence of which was estimated with Kaplan-Meier analysis. Multivariate Cox regression analysis was used to analyze correlations between genotype variants and the occurrence of BM. Results:In analysis of individual SNPs, the GT/GG genotype of AKT1: rs2498804, CT/TT genotype of AKT1: rs2494732 and AG/AA genotype of PIK3CA: rs2699887 were associated with higher risk of BM at 24 months' follow-up (respective hazard ratios [HRs] 1.860, 95% confidence interval [CI] 1.199-2.885, P=0.006; HR 1.902, 95% CI 1.259-2.875, P = 0.002; and HR 1.933, 95% CI 1.168-3.200, P=0.010). We further found that these SNPs had a cumulative effect on BM risk, with that risk being highest for patients carrying both of these unfavorable genotypes (P=0.003). Conclusions:Confirmation of our findings, the first to indicate that genetic variations in PI3K-AKT-mTOR can predict BM, in prospective studies would facilitate stratification of patients for BM prevention trials.

老马 · 发表于 2014-1-8 18:40:25

埃克替尼治疗非小细胞肺癌脑转移的回顾性研究.pdf (953.49 KB, 下载次数: 268)

老马 · 发表于 2014-1-8 18:45:29

EGFR-TKI and lung adenocarcinoma with CNS relapse.pdf (341.21 KB, 下载次数: 63)

老马 · 发表于 2014-1-8 19:25:55

Kim, J.E.; Lee, D.H.; Choi, Y.; Yoon, D.H.; Kim, S.W.; Suh, C.; Lee, J.S. Epidermal growth
receptor tyrosine kinase inhibitors as a first-line therapy for non-smokers with adenocarcinoma
of the lung having asymptomatic synchronous brain metastases. Lung Cancer 2009, 65, 351–354.

Heon, S.; Yeap, B.Y.; Britt, G.J.; Costa, D.B.; Rabin, M.S.; Jackman, D.M.; Johnson, B.E.
Development of central nervous system metastases in patients with advanced non-small cell lung
cancer and somatic EGFR mutations treated with gefinitib or erlotinib. Clin. Cancer Res. 2010,
16, 5873–82.

豆沙包呀 · 发表于 2014-1-12 15:19:11

椰子112 发表于 2011-10-15 21:29
我妈妈脑膜转移，当时吴一龙让全脑放疗。。。说有效率20~30% 所以我们没放。。。
回来以后停了10天靶向药 ...

麻烦问一下吴一龙的号怎么能挂上？直接挂专家号吗

qqabc · 发表于 2014-1-14 20:28:29

老马发表于 2014-1-8 19:25
Kim, J.E.; Lee, D.H.; Choi, Y.; Yoon, D.H.; Kim, S.W.; Suh, C.; Lee, J.S. Epidermal growth
recepto ...

找不到下载啊

linruyicn · 发表于 2014-1-17 15:01:45

谢谢，收集资料，

阿Q · 发表于 2014-2-13 09:29:44

老马发表于 2013-12-13 12:14
罗氏的Brain Shuttle技术
http://www.roche.com/research_and_development/what_we_are_working_on/resear ...

罗氏的Brain Shuttle technology，能有效地将研究性抗体通过血脑屏障(BBB)转移进入大脑。
　
这个还只是临床前模型，到二三期临床不知道需要几年呢……

huanzi · 发表于 2014-2-13 15:00:11

本帖最后由 huanzi 于 2014-2-13 15:04 编辑

老马老师！你好！脑转信息又从头看到尾，，除了易，特入脑，还有埃克替尼，我是19突变，对易，特，埃克替尼是有效的，易，用10个月，脑转后用特8个月，现4002，收效一般，准备下月换药，2992一个月无效，299804是否试试，易特都用了换埃克替尼有用吗？看到前面的病友联合替莫唑胺，我想试试，请指导，一直无放疗，多发脑转，大部分得到好转，也发现新病灶，不知是否还可以继续药物控制，望病友们给予自身体会，在这里多谢了！