Материалы доступны только для специалистов сферы здравоохранения. Авторизуйтесь или зарегистрируйтесь.
Опыт применения гефитиниба в лечении немелкоклеточного рака легких в Орловской области
Опыт применения гефитиниба в лечении немелкоклеточного рака легких в Орловской области
Материалы доступны только для специалистов сферы здравоохранения. Авторизуйтесь или зарегистрируйтесь.
Аннотация
В статье представлены анализ и оценка эффективности лечения пациентов с немелкоклеточным раком легкого (НМРЛ), получавших селективный ингибитор тирозинкиназы ERFR гефитиниб в 1-й и 2-й линиях терапии с 2006 по 2009 г. в Орловском областном онкологическом диспансере. Были проанализированы сведения о 45 пациентах с НМРЛ стадий Т1-4 N0-3 М0-1 в возрасте от 41 до 75 лет, часть из которых ранее получали комбинированное и комплексное лечение. Продолжительность жизни до прогрессирования составила 6 (гефитиниб) и 7,5 мес (доцетаксел) при применении препаратов во 2-й линии терапии НМРЛ. Установлена высокая эффективность гефитиниба при лечении НМРЛ. Показано, что он может служить препаратом выбора как для лечения больных НМРЛ во 2-й линии, так и для лечения ослабленных и истощенных пациентов с подобной патологией в 1-й линии терапии.
________________________________________________
Полный текст
Список литературы
1. Злокачественные новообразования в России в 1998 году (заболеваемость и смертность). Под ред. В.И.Чиссова, В.В.Старинского. М.,1999; с. 284.
2. World Health Organization. Histological Typing of Lung Tumors. 2nd ed.Geneva: World Health Organization, 1981.
3. Albain KS, Crowley JJ, Le Blanc M. et al. Survival determinants in extensive stage non?small cell lung cancer. The Southwest Oncology Group experience. J Clin Oncol 1991; 9: 1618–26.
4. Kelly K, Crowley J, Bunn RB et al. A randomized phase III trial of paclitaxel plus carboplatin (PC) versus vinorelbine plus cisplatin (VC) in untreated advanced non5small cell lung cancer (NSCLC): A Southwest Oncology Group (SWOG) trial Proc. ASCO 1999; 18: 17–77.
5. Non Small Cell Lung Cancer Collaborative Group. Chemotherapy in non small cell lung cancer. A meta?analysis using updated data on individual patients from 52 randomized clinical trials. Brit Med J 1995; 311 (7010): 899–909.
6. Smith IE. Chemotherapy of advanced stage non SCLC. Impact on quality of life and symptom control. Lung Cancer. 1997; 18 (Suppl. 2): 67.
7. Hopwood P. Evidence for the impact on quality of life Ibid: P. 66.
8. Поддубная И.В. Терапия гефитинибом в сравнении с доцетакселом у пациентов с НМКРЛ, ранее получавших терапию: рандомизированное исследование 3-й фазы (INTEREST). Новые данные о лечении немелкоклеточного рака легкого (НМКРЛ). Расширенный реферат. Соврем. онкология. 2009; 1 (11).
9. Shepherd FA, Dancey J, Ramlau R et al. Prospective randomized trial of docetaxel versus best supportive care in patients with non-small-cell lung cancer previously treated with platinum-based chemotherapy. J Clin Oncol 2000; 18: 2095–103.
10. Fossella FV, Devore R, Kerr RN et al. Randomized phase III trial of docetaxel versus vinorelbine or infosfamide in patients with advanced non-small-cell lung cancer previously treated with platinum-containing chemotherapy regimens. J Clin Oncol 2000; 18: 235–462.
11. Hanna N, Shepherd FA, Fossella FV et al. Randomized phase III trial of pemetrexed versus docetaxel in patients with non-small-cell lung cancer previously treated with chemotherapy. J Clin Oncol 2004; 22: 1589–97.
12. Cufer T, Vrdoljak E, Caafar R et al. Phase II, open-label, randomized study (SIGN) of single-agent gefitinib (IRESSA) or docetaxel as second-line therapy in patients with advanced (stage IIIb or IV) non-small-cell lung cancer. Anticancer Drugs 2006; 17: 401–9.
13. Herbst RS, Fukuoka M, Baselga J. Gefitinib a novel targeted approach to treating cancer. Nat Rev Cancer 2004; 4: 956–65.
14. Shepherd FA, Rodrigues PJ, Ciuleanu T et al. Erlotinib in previously treated non-small-cell lung cancer. N Engl J Med 2005; 353: 123–32.
15. Fukuoka M, Yano S, Giaccone G et al. Multi-institutional randomized phase II trial of gefitinib for previously treated patients with advanced non-small-cell lung cancer. J Clin Oncol 2003; 21: 223–746.
16. Kris MG, Natale RB, Herbst RS et al. Efficacy of gefitinib, an inhibitor of the epidermal growth factor receptor tyrosine kinase, in symptomatic patients with non-small-cell lung cancer. A randomized trial. JAMA 2003; 290: 214–958.
17. Maruyama R, Nishiwaki Y, Tamura T et al. Phase III study, V-1532, of gefitinib versus docetaxel in previously treated Japanese patients with non-small-cell lung cancer. J Clin Oncol 2008; 26: 424–52.
18. Thatcher N, Chang A, Parikh P et al. Gefitinib plus best supportive care in previously treated patients with refractory advanced non-small-cell lung cancer: results form a randomised, placebo-controlled, multicentre study (Iressa Survival Evaluation in Lung Cancer). Lancet 2005; 366: 1527–37.
19. Tony SMok, Yi-Long Wu. Gefetinib or Carboplatin-Paclitaxel in Pulmonary Adenocarcinoma. The New England Journal of Medicine; 361 (10): 947–57.
20. Lynch TJ, Bell DW, Sordell R et al. Activating mutations in the epidermal growht factor receptor underlying responsiveness of non-small-cell lung cancer to gefitinib. N Engl J Med 2004; 350: 2129–39.
21. Tsao M-S, Sakurada A, Cutz J-C et al. Erlotinib in lung cancer molecular and clinical predictors of outcome. N Engl J Med 2005; 353: 133–44.
22. Pao W, Wang TY, Riely GJ et al. KRAS mutations and primary resistance of lung adenocarcinomas to gefitinib or erlotinib. PLoS Med 2005; 17.
23. Eberhard DA, Johnson BE, Amler LC et al. Mutations in the epidermal growth factor receptor and in KRAS are predictive and prognostic indicators in patients with non-small-cell jung cancer treated with chemotherapy alone and in combination with erlotinib. J Clin Oncol 2005; 23: 585–668.
2. World Health Organization. Histological Typing of Lung Tumors. 2nd ed.Geneva: World Health Organization, 1981.
3. Albain KS, Crowley JJ, Le Blanc M. et al. Survival determinants in extensive stage non?small cell lung cancer. The Southwest Oncology Group experience. J Clin Oncol 1991; 9: 1618–26.
4. Kelly K, Crowley J, Bunn RB et al. A randomized phase III trial of paclitaxel plus carboplatin (PC) versus vinorelbine plus cisplatin (VC) in untreated advanced non5small cell lung cancer (NSCLC): A Southwest Oncology Group (SWOG) trial Proc. ASCO 1999; 18: 17–77.
5. Non Small Cell Lung Cancer Collaborative Group. Chemotherapy in non small cell lung cancer. A meta?analysis using updated data on individual patients from 52 randomized clinical trials. Brit Med J 1995; 311 (7010): 899–909.
6. Smith IE. Chemotherapy of advanced stage non SCLC. Impact on quality of life and symptom control. Lung Cancer. 1997; 18 (Suppl. 2): 67.
7. Hopwood P. Evidence for the impact on quality of life Ibid: P. 66.
8. Поддубная И.В. Терапия гефитинибом в сравнении с доцетакселом у пациентов с НМКРЛ, ранее получавших терапию: рандомизированное исследование 3-й фазы (INTEREST). Новые данные о лечении немелкоклеточного рака легкого (НМКРЛ). Расширенный реферат. Соврем. онкология. 2009; 1 (11).
9. Shepherd FA, Dancey J, Ramlau R et al. Prospective randomized trial of docetaxel versus best supportive care in patients with non-small-cell lung cancer previously treated with platinum-based chemotherapy. J Clin Oncol 2000; 18: 2095–103.
10. Fossella FV, Devore R, Kerr RN et al. Randomized phase III trial of docetaxel versus vinorelbine or infosfamide in patients with advanced non-small-cell lung cancer previously treated with platinum-containing chemotherapy regimens. J Clin Oncol 2000; 18: 235–462.
11. Hanna N, Shepherd FA, Fossella FV et al. Randomized phase III trial of pemetrexed versus docetaxel in patients with non-small-cell lung cancer previously treated with chemotherapy. J Clin Oncol 2004; 22: 1589–97.
12. Cufer T, Vrdoljak E, Caafar R et al. Phase II, open-label, randomized study (SIGN) of single-agent gefitinib (IRESSA) or docetaxel as second-line therapy in patients with advanced (stage IIIb or IV) non-small-cell lung cancer. Anticancer Drugs 2006; 17: 401–9.
13. Herbst RS, Fukuoka M, Baselga J. Gefitinib a novel targeted approach to treating cancer. Nat Rev Cancer 2004; 4: 956–65.
14. Shepherd FA, Rodrigues PJ, Ciuleanu T et al. Erlotinib in previously treated non-small-cell lung cancer. N Engl J Med 2005; 353: 123–32.
15. Fukuoka M, Yano S, Giaccone G et al. Multi-institutional randomized phase II trial of gefitinib for previously treated patients with advanced non-small-cell lung cancer. J Clin Oncol 2003; 21: 223–746.
16. Kris MG, Natale RB, Herbst RS et al. Efficacy of gefitinib, an inhibitor of the epidermal growth factor receptor tyrosine kinase, in symptomatic patients with non-small-cell lung cancer. A randomized trial. JAMA 2003; 290: 214–958.
17. Maruyama R, Nishiwaki Y, Tamura T et al. Phase III study, V-1532, of gefitinib versus docetaxel in previously treated Japanese patients with non-small-cell lung cancer. J Clin Oncol 2008; 26: 424–52.
18. Thatcher N, Chang A, Parikh P et al. Gefitinib plus best supportive care in previously treated patients with refractory advanced non-small-cell lung cancer: results form a randomised, placebo-controlled, multicentre study (Iressa Survival Evaluation in Lung Cancer). Lancet 2005; 366: 1527–37.
19. Tony SMok, Yi-Long Wu. Gefetinib or Carboplatin-Paclitaxel in Pulmonary Adenocarcinoma. The New England Journal of Medicine; 361 (10): 947–57.
20. Lynch TJ, Bell DW, Sordell R et al. Activating mutations in the epidermal growht factor receptor underlying responsiveness of non-small-cell lung cancer to gefitinib. N Engl J Med 2004; 350: 2129–39.
21. Tsao M-S, Sakurada A, Cutz J-C et al. Erlotinib in lung cancer molecular and clinical predictors of outcome. N Engl J Med 2005; 353: 133–44.
22. Pao W, Wang TY, Riely GJ et al. KRAS mutations and primary resistance of lung adenocarcinomas to gefitinib or erlotinib. PLoS Med 2005; 17.
23. Eberhard DA, Johnson BE, Amler LC et al. Mutations in the epidermal growth factor receptor and in KRAS are predictive and prognostic indicators in patients with non-small-cell jung cancer treated with chemotherapy alone and in combination with erlotinib. J Clin Oncol 2005; 23: 585–668.
Авторы
Р.А.Голубенко, Г.Б.Громов, В.И.Вишневский
ГОУ ВПО Орловский государственный университет
ГОУ ВПО Орловский государственный университет
________________________________________________
Цель портала OmniDoctor – предоставление профессиональной информации врачам, провизорам и фармацевтам.