责任编辑:互助君 封面图片来源:摄图网正版图库 温馨提示: 1、如果您想看到我们的内容,请点击右上角“SLE互助圈”进行关注;2、如果您想感受SLE大家庭的温暖,请点击左下角“阅读原文”进行下载;3、如果您想给我们提出意见和建议,请在下方留言区写下您的字句; 专业知识病友交流加入觅健SLE病友互助群扫码入群 厄洛替尼联合贝伐珠单抗的组合方案推荐。","8:1"],[20,"","24:"25Xw"|7:3|linespacing:"150""],[20,"","24:"zODD"|7:3|linespacing:"150""],[20,"来自日本多中心的Ⅲ期NEJ026研究的结果显示,厄洛替尼 贝伐珠单抗和厄洛替尼单药进行比较,两组的中位PFS分别为16.9个月和13.3个月,具有显著的统计学差异,患者的疾病进展或死亡风险降低近40%。同时在药物安全性上,也是可以接受。"],[20,"","24:"6sLD"|7:3|linespacing:"150""],[20,"","24:"m9PU"|7:3|linespacing:"150""],[20,"更好的消息是,目前,这两种药物都进入了医保,贝伐珠单抗从过去的月花费几万到可以实现月自付几千,性价比是非常高的了。随着国内研究的进一步深入,在不久的将来,该组合或许有望升级为一线治疗。免疫治疗在肿瘤治疗中逐渐站稳脚跟,新的药物也层出不穷,2019版指南及时更新了免疫治疗的策略,为我们提供了最新最前沿的思路。"],[20,"","24:"ERyc"|7:3|linespacing:"150""],[20,"","24:"Sh9a"|7:3|linespacing:"150""],[20,"靶向治疗药物更加多样化","8:1"],[20,"","24:"LcAI"|7:1|linespacing:"150""],[20,"","24:"Bm5e"|7:3|linespacing:"150""],[20,"此次指南中"],[20,"阿来替尼作为Ⅳ期ALK融合阳性NSCLC一线治疗Ⅰ级推荐,并且是优先推荐(1A类证据),与NCCN指南保持一致。","8:1"],[20,"","linespacing:"150""],[20,"ALK 的肺癌患者是预后比较好的类型,而第一代ALK抑制剂克唑替尼对ALK 患者的有效率高达60%-70%,效果还是不错的。但它有两个缺点:"],[20,"一是控制不了脑转移,二是容易耐药,不少患者用药一年左右,肿瘤就会卷土重来。","27:"11"|8:1"],[20,"","linespacing:"150""],[20,"所以,在这种情况下,科学家们持续在研发新一代的ALK抑制剂,比如科普君曾多次介绍过的这个新一代ALK抑制剂——Alectinib(中文名:阿来替尼)。"],[20,"","linespacing:"150""],[20,"据大型三期临床试验数据显示:针对ALK 的肺癌患者,确诊后直接使用阿来替尼比克唑替尼好很多,有效率高达80%-90%,无进展生存时间更是创造了晚期肺癌治疗史上的新高度。"],[20,"","linespacing:"150""],[20,"而且经过两年随访,阿来替尼组的中位无进展生存期(PFS)历史性的达到了34.8个月,而克唑替尼组只有10.9个月,阿来替尼提高了足足3倍的无进展生存期,这意味着50%的癌症患者可以轻轻松松实现近3年的无进展生存,就是跟正常人一样生活。具体数据如下图:"],[20,"","linespacing:"150""],[20,{"gallery":"https://uploader.shimo.im/f/HEVOGL2tdSHCro64.png!thumbnail"},"29:0|30:0|3:"757"|4:"auto"|crop:""|frame:"none"|ori-height:"576"|ori-width:"757""],[20,"","7:1|linespacing:"150""],[20,"","linespacing:"150""],[20,"对于大部分靶向药物来说,中位无进展生存期大多在10-12个月;人尽皆知的“肺癌神药”-奥希替尼一线用于EGFR突变的肺癌患者,PFS达到18.9个月;而阿来替尼的PFS历史性的达到了34.8个月,接近三年,这绝对开创了一个新时代,也意味着“把晚期肺癌变成慢性病”,再也不是遥不可及的梦想,已经成为现实。"],[20,"","linespacing:"150""],[20,"","24:"0Ww9"|linespacing:"150""],[20,"更接地气","8:1"],[20,"","24:"Q5Fg"|7:1|linespacing:"150""],[20,"","24:"bLuC"|linespacing:"150""],[20,"指南看点不仅于此,"],[20,"我国自主研发的安罗替尼也出现在指南中,","8:1"],[20,"这是一个良好的开端,也是“国货”迈出的重大一步。"],[20,"","24:"Xw98"|linespacing:"150""],[20,"","24:"Ump0"|linespacing:"150""],[20,"在安罗替尼出现以前,国内没有标准的晚期非小细胞肺癌三线治疗方案。也就是,当第一套方案、第二套方案都失败以后,第三套方案到底用不用、用什么、怎么用,学术界存在极大的争议,指南也没有推荐的药物。","1:"initial""],[20,"","24:"uAJ1"|linespacing:"150""],[20,"","24:"K2FG"|linespacing:"150""],[20,"安罗替尼,是国内自主研发的抗肿瘤新药。其抗癌原理也是“肿瘤饥饿疗法”,因为癌细胞生长速度快,需要大量的“营养”支持。为了获得足够的“营养”,狡猾的癌细胞千方百计的进行资源掠夺,其中一个重要策略就是生成更多的血管,让血液更多的穿过肿瘤组织,带来更多的“营养”,促进肿瘤的生长和转移。而安罗替尼能够有效的抑制血管生成,切断“营养”供应,“饿死”癌细胞。","1:"initial""],[20,"","24:"0Fgh"|linespacing:"150""],[20," "],[20,"","24:"KA6I""],[20,"随着更多临床数据的公布,我们有理由相信,安罗替尼会为癌症患者提供更多的选择。未来,安罗替尼不可能一直单打独斗,与其它化疗药物或 PD-1/PD-L1药物联合,将会有更多、更广泛的应用前景,我们拭目以待。"],[20,"","linespacing:"150""],[20,"","24:"g9zn,e0kn,iiZV,DZjr,cfrQ,hDfc,kms9,jbWG,jOsO,xYuQ,EXj8,qyyR,hkhv,YIzf,DKxT,7hTi,nsO0,ptjK,V7s1,lbMO,zJsr,sT0Q,gA71,6xOq,LAiN,mNYk,ixAB,lgGg,Mnu9""],[20,"","24:"KNBI"|7:3|linespacing:"150""],[20,"","24:"FL7m"|7:3|linespacing:"150""],[20,"参考文献:","27:"10""],[20,"","7:3"],[20,"[1] Tamura, T., et al., Three-Year Follow-Up of an Alectinib Phase I/II Study in ALK-Positive Non-Small-Cell Lung Cancer: AF-001JP. J Clin Oncol, 2017: p. JCO2016705749.","27:"10""],[20,"","7:3"],[20,"[2] Antonia S J , Villegas A , Daniel D , et al. Durvalumab after Chemoradiotherapy in Stage III Non-Small-Cell Lung Cancer[J]. New England Journal of Medicine, 2017, 377(20):1919.","27:"10""],[20,"","7:3"],[20,"[3] Peters, S., et al., Alectinib versus Crizotinib in Untreated ALK-Positive Non-Small-Cell Lung Cancer. N Engl J Med, 2017.","27:"10""],[20,"","7:3"]]" style="max-width: 100%;overflow-wrap: break-word;box-sizing: border-box !important;">点分享点点赞点在看