我父亲肺鳞癌的治疗贴(2014年3月1日驾鹤西去）

老马的帖子一定要顶，祝福叔叔

前天开始把GNC Q10改成能气郎Q10了，一天吃3粒。
4 u# M  z7 x$ K9 C昨天开始打榄香烯，浙江入医保。
下周去做生物治疗。

请问老马叔，我爸爸作为预防性化疗，CEA值的统计如下：

手术前5月28日（5.4ng/ml）；手术后6月15日（2.72ng/ml）；第一次化疗前6月25日（2.8ng/ml）；第二次化疗后8月3日（3.08ng/ml） ，化疗方案为培美曲塞加顺铂。
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第二次化疗后CEA有没有继续下降反而微升，是否说明，这个化疗方案对我父亲效果不好甚至是无效的呢？

你不能光查cea这个指标，还得同时查其它肿瘤指标，ca125,cy211,nse,ca199，c反应蛋白，铁蛋白等等。

老马，有人都叫你叔了。。

棒海狸 发表于 2012-8-5 09:15

                               
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5 h# [2 E- v# I1 {0 j4 j! {请问老马叔，我爸爸作为预防性化疗，CEA值的统计如下：

! ?" s5 V0 g  L( }7 Y4 ~手术前5月28日（5.4ng/ml）；手术后6月15日（2. ...

哦~~谢谢指导~~一直比较焦虑。

her2基因在肺癌中的研究进展.pdf (292.5 KB, 下载次数: 124)

2012-8-5 20:07 上传

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HER2/neu(erbB2)基因，编码蛋白大小为185KDa，具有酪氨酸蛋白激酶活性，为表皮生长因子受体(EGFR)家族成员，与EGFR高度同源。HER2/neu蛋白可以与家族其他成员形成异源二聚体，从而发挥强有力的肿瘤信号传导作用。研究显示，HER2/neu介导的信号传导与肿瘤的形成、增殖、转移、侵袭及放化疗耐受有关。约1/3非小细胞肺癌(NSCLC)存在HER2/neu过表达，其在NSCLC形成、增殖、转移、侵袭等方面的作用尚需进一步研究证实。

Clin Lung Cancer. 2004 Jan;5(4):231-6.

Trastuzumab plus docetaxel in HER2/neu-positive non-small-cell lung cancer: a California Cancer Consortium screening and phase II trial.
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  o( s9 M2 L8 s; V, u9 u5 C6 G7 I" f1 uLara PN Jr, Laptalo L, Longmate J, Lau DH, Gandour-Edwards R, Gumerlock PH, Doroshow JH, Gandara DR; California Cancer Consortium.

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Source

% q4 |) o  X  i) \+ [0 H7 K" vDivision of Hematology/Oncology, Department of Internal Medicine, University of California Davis Cancer Center, Sacramento, CA 95817, USA. primo.lara@ucdmc.ucdavis.edu
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0 X$ j/ r4 H$ c; Y( G" QAbstract
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HER2 is reported to be overexpressed in 20% of cases of non-small-cell lung cancer (NSCLC), principally adenocarcinoma. Trastuzumab is a monoclonal antibody against HER2 that, when combined with a taxane, improves survival compared with chemotherapy alone in advanced breast cancer. In view of these observations, we conducted a phase II HER2 screening and efficacy trial of trastuzumab plus weekly docetaxel in cases of advanced NSCLC in which primary platinum-based therapy had failed. Patients with advanced or metastatic NSCLC were screened for HER2 overexpression by immunohistochemistry. Patients with HER2-positive tumors (2+ or 3+) were initially randomized to either single-agent trastuzumab or docetaxel. After completing 2 treatment cycles, all patients went on to receive the trastuzumab/docetaxel combination regardless of response to the single agents. Treatment consisted of docetaxel 30 mg/m2 weekly for 6 weeks followed by a 2-week break and trastuzumab 4 mg/kg intravenously on week 1 followed by 2 mg/kg per week thereafter. Cycle length was 8 weeks. Sixty-nine patients with NSCLC (33 men, 36 women) were screened between August 1999 and March 2001. Only 13 patients (19%) had HER2-positive disease; all 13 enrolled in the efficacy trial. Of 9 patients receiving docetaxel alone, 1 partial response (PR) was seen. None responded to trastuzumab alone. The overall outcomes to the sequence of single-agent therapy followed by combination therapy included a PR rate in 8% of cases, stable disease in 23%, progression in 46%, and nonassessable disease in 23%. Estimated event-free and overall survival times were 4.3 and 5.7 months, respectively. Treatment was well tolerated. The screening component of this trial demonstrated that the target population for trastuzumab therapy in NSCLC is relatively small. Because of the limited clinical activity of trastuzumab-based therapy in this cohort and the similar disappointing reports from other studies of trastuzumab in NSCLC, this trial was closed to further accrual. In view of the limited target population for HER2 inhibition, future efforts and resources should be directed toward molecular targets other than HER2 in NSCLC.
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Cancer. 2005 Apr 15;103(8):1670-5.

Lack of trastuzumab activity in nonsmall cell lung carcinoma with overexpression of erb-B2: 39810: a phase II trial of Cancer and Leukemia Group B.
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) _! d7 d0 P/ {; e5 Z6 f0 S4 fClamon G, Herndon J, Kern J, Govindan R, Garst J, Watson D, Green M; Cancer and Leukemia Group B.
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8 z$ \6 d3 F* iDepartment of Internal Medicine, University of Iowa, Iowa City, Iowa 52242-1099, USA. gerald-clamon@uiowa.edu


3 Z) y2 [" c; t. n3 d$ BAbstract

9 C- A3 q& s% H  mBACKGROUND:

The overexpression of HER-2 occurs in a minority of patients with nonsmall cell lung carcinoma. Trastuzumab, which is a monoclonal antibody to HER-2, is an effective treatment in some women with breast carcinomas that overexpress HER-2, as demonstrated by immunohistochemistry. The objective of this Phase II study was to determine whether trastuzumab would effect responses in patients with nonsmall cell lung carcinoma who had tumors that overexpressed HER-2.
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# {- s" h. P8 o5 H# iMETHODS:
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# e" Z) O5 r  k" F, h8 `9 pPatients were required to have Stage IIIB or Stage IV nonsmall cell lung carcinoma and tumors with 2+ or 3+ expression of HER-2, as determined with immunohistochemistry, and they may have received up to 1 prior chemotherapy regimen. Trastuzumab at a dose of 4 mg/kg was given intravenously on Week 1; then, weekly doses of 2 mg/kg were given. Response revaluation was performed every 8 weeks.

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Among 209 screened patients, 24 patients (11%) had tumors with 2+ or 3+ expression of HER-2. One patient achieved a partial response, and one patient experienced a treatment-related death due to pulmonary toxicity.
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CONCLUSIONS:
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$ b! S; r8 ]9 _  T. fSingle-agent trastuzumab did not exhibit significant clinical activity against nonsmall cell lung carcinoma when HER-2 expression levels were measured by immunohistochemistry.