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High Quality - Low Cost Anti-Cancer Drugs

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NICE said Tarceva showed some clinical benefit, and from recent clinical trials Roche estimates that it can potentially extend life by around 3.3 months.
In one study, tissue from 1,500 lung cancers was tested for a gene mutation in a spot called EGFR exon 20. Of these cancers, 32 had the EGFR exon 20 mutation, which seemed to be more common in people who had never smoked. Researchers believe that lung cancer that tests positive for the EGFR exon 20 mutation may not respond to targeted drugs such as erlotinib (Tarceva) or gefitinib (Iressa). In such cases, other targeted treatments (or perhaps chemotherapy) may be a better choice. People with more common mutations in exon 19 and exon 21 are much more likely to benefit from erlotinib or gefitinib.
www.viveramebel.ru/forum/boltalka/8454-p...otinib-used-for.html
* Cele mai frecvente reactii adverse aparute in urma terapiei de intretinere cu Tarceva au fost eruptiile cutanate (49 la suta) si diareea (20 la suta). Eruptiile cutanate de gradul 3 au fost resimtite de 6 la suta dintre pacienti, in timp ce doar 2 la suta dintre acestia au prezentat diaree de gradul 3. Nu au fost semnalate cazuri ale acestor simptome dezvoltate la gradul 4. Informatii de siguranta despre Tarceva
14. ^ Dr Dubey; Dr Howard L. (Jack) West (03 2009). “Learning from the Tumor: When Drugs Stop Working”. GRACE::Lung Cancer . Seattle, WA. Global Resource for Advancing Cancer Education (GRACE). cancergrace.org/lung/2009/03/09/sd-egfr-mechs-of-resistance/. Retrieved 26 February 2011. “… the tumor develops a secondary mutation that was described as T790M mutation. This new mutation blocks the binding of tarceva in the tumor so that tarceva cannot work anymore. … MET is a gene that helps tumor grow. … European investigators studied lung tumors that were removed from people who had lung cancer surgery… survival was shorter when high amounts of MET was present in the tumor…. T790M and MET are the biggest reasons why drugs like tarceva eventually stop working.”
Popolazione pediatrica . la sicurezza e l’efficacia di erlotinib in pazienti di età inferiore a 18 anni non sono state stabilite. Non è raccomandato l’impiego di Tarceva in pazienti pediatrici.
Si toma más Tarceva del que debiera Contacte inmediatamente con su médico o farmacéutico. Puede que tenga un aumento de los efectos adversos y su médico tenga que interrumpir su tratamiento.
While attempts to improve survival in patients with resected NSCLC are likely to involve targeted drugs, a significant benefit can only be achieved with the use of molecular predictors. In a study reported by Janjigian and colleagues, 10 167 patients with resected NSCLC harboring activating EGFR mutations were evaluated, including 56 who received adjuvant gefitinib or erlotinib and 111 who did not receive adjuvant EGFR tyrosine kinase inhibitors. The 2-year disease-free survival was higher for the group receiving adjuvant EGFR tyrosine kinase inhibitors, although it did not reach statistical significance (89% vs 72%, hazard ratio = 0.53, P = .06), likely due to the small patient population.
www.cdo-krsk.ru/forum/onlajn-seminar/591...rceva-nice-2014.html
Jackman DM, Yeap BY, Sequist LV, Lindeman N, et al.Exon 19 deletion mutations of epidermal growth factor receptor are associated with prolonged survival in non-small cell lung cancer patients treated with gefitinib or erlotinib. Clin Cancer Res 2006; 12 :3908–3914. | Article | PubMed | ISI | ChemPort |
The incidence of HPV infection in the series was limited. It was detected in 1 out of 40 samples (62-year-old woman, non-smoker, with lung ADC and areas of BAC, native EGFR, responsive to Erlotinib for 7 months). No variables influenced the percentage of infection, although this is conditioned by the size of the series (Table 1 ). Neither sex (0% males vs 5% females, P =.31) nor age (younger or older than 65, P =.26) showed an influence. There were no differences among smokers, mild-smokers, ex-smokers or non-smokers ( P =.56), between biopsy, cell button or cytology ( P =.36) or between squamous-cell carcinomas, ADC with or without BAC or NSCLC without defined histology ( P =.1). There were no differences between samples with EGFR mutation, native EGFR or unstudied ( P =.68), or related with response ( P =.66) or progression-free survival with Erlotinib ( P =.93). The limited sample could not confirm differences between response to Erlotinib of NSCLC with the mutation or without it.
Erlotinib With Or Without Crizotinib (PF-02341066) (UW09020)
www.cpja.org.uk/forum/viewtopic.php?f=9&t=1796887
Moore MJ, Goldstein D, Hamm J, Figer A, Hecht JR, Gallinger S, et al . Erlotinib plus gemcitabine compared with gemcitabine alone in patients with advanced pancreatic cancer: a phase III trial of the National Cancer Institute of Canada clinical trials group. J Clin Oncol 2007; 25. 1960–6. | Article | PubMed | ISI | ChemPort |
Immunohistochemical analysis of cellular proliferation. Immunofluorescence images of Ki67 (green) nuclear labelling of cytokeratin (CK, red) positive neoplastic cells in sections of xenografted tumours from an untreated (A) and Erl + Cet treated ( BALB/c nude mouse. C . bar graph illustrating the effect of the different treatments on the percentage of cycling (Ki67pos) neoplastic cells within the tumour. CTRL: untreated, ERL: erlotinib, CET: cetuximab, COMB: erlotinib + cetuximab. * p < 0.01 vs CTRL.
Dhruva N, Socinski MA. Carcinomatous meningitis in non-small-cell lung cancer: Response to high-dose erlotinib. J Clin Oncol 2009;27:e31-2. [ PUBMED ] [ FULLTEXT ]
Moore MJ, Goldstein D, Hamm J, Kotecha J, Gallinger S, Au HJ, Nomikos D, Ding K, Ptaszynski M, and Parulekar W ( 2005 ) Erlotinib improves survival when added to gemcitabine in patients with advanced pancreatic cancer. A phase III trial of the National Cancer Institute of Canada Clinical Trials Group. Proc Am Soc Clin Oncol 121 : Abs. 77.
Erlotinib is an effective treatment for NSCLC patients and has been registered as a second and third-line treatment of NSCLC regardless of EGFR mutation status [ 5 ].
A Study of Onartuzumab in Combination With Erlotinib in Patients With MET-Positive Stage IIIB or IV Non-Small Cell Lung Cancer Carrying an Activating Epidermal Growth Factor Receptor (EGFR) Mutation
Use erlotinib as directed by your doctor. Check the label on the medicine for exact dosing instructions.
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The National Cancer Institute of Canada Clinical Trials Group performed a phase III trial (BR.21) that compared erlotinib with placebo in patients who had disease progression during one or two lines of chemotherapy and who were not eligible for further chemotherapy (Table 2 ). Patients assigned to the erlotinib arm experienced a statistically significantly longer PFS and OS than those in the BSC group [5 ]. Patients assigned to the erlotinib arm also experienced a statistically significantly longer median time to deterioration in cough, dyspnea, and pain, and improvement in physical function and global QoL [18 ].
Pao W, Miller VA, Politi KA, Riely GJ, Somwar R, Zakowski MF, Kris MG, Varmus H (2005) Acquired resistance of lung adenocarcinomas to gefitinib or erlotinib is associated with a second mutation in the EGFR kinase domain. PLoS Med 2:e73 CrossRef PubMed Google Scholar
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In our experience, erlotinib was found slightly superior to gefitinib in objective response rate and disease control rate, but in terms of time to progression and survival after treatment, the two agents were statistically comparable.
Cases of interstitial lung disease (ILD) have been observed in patients receiving erlotinib at an overall incidence of about 0.8% (patients in the placebo group had a similar incidence of ILD). Reports have included interstitial pneumonia, pneumonitis, acute respiratory distress syndrome, pulmonary fibrosis, andalveolitis. Patients often present with the acute onset of dyspnea, sometimes associated with cough or low-grade fever, often becoming severe within a short time and requiring hospitalization. Symptoms started from 5 days to >9 months (median 47 days) after initiating erlotinib therapy. Most of the cases were associated with confounding or contributing factors such as concomitant/prior chemotherapy, prior radiotherapy, pre-existing parenchymal lung disease, metastatic lung disease, or pulmonary infections.
. Prospective assessment of discontinuation and reinitiation of erlotinib or gefitinib in patients with acquired resistance to erlotinib or gefitinib followed by the addition of everolimus. Clin Cancer Res 13. 5150 - 5155. 2007.
Lemos C, Kathmann I, Hoebe EK, Jansen G, Peters GJ (2006a) The EGFR TK inhibitor gefitinib (Iressa), but not erlotinib (Tarceva), is a substrate for BCRP: impact of cellular folate status on biological activity. Annals Oncol 17 (Suppl 3): iii46 (abstract)
For further information please call 1-877-Tarceva (1-877-827-2382).
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Cigarette smoking decreased erlotinib exposure. Avoid smoking tobacco (CYP1A2 inducer) and avoid concomitant use of TARCEVA with moderate CYP1A2 inducers (e.g. teriflunomide, rifampin, or phenytoin). Increase the TARCEVA dosage in patients that smoke tobacco or when co-administration with moderate CYP1A2 inducers is unavoidable [see Dosage and Administration (2.4 ) and Clinical Pharmacology (12.3 )] .
Hello, my 78 yo mother, non smoker EGFR exon 19 deletion +, has been on 150mg Tarceva for 8 weeks and completed 14 fractions of WBRT almost 4 weeks ago. She is extremely fatigued and is losing weight rapidly. Today the onc took her off Tarceva until next appointment and ordered another scan. She seemed to be having a good response to Tarceva, but onc thinks her fatigue is due to Tarceva, not effects of radiation since that’s 4 weeks out. Could reducing dose help? Tumor marker increased, although her marker has always been low. I’m wondering about the experience of others-has anybody else had this level of fatigue and would dose make a difference? Thanks for any insights.
zheschool3.ru/index.php/forum/razdel-pre...-26-tarceva-overdose
Indikation: Tarceva ist zur Behandlung von Patienten mit lokal fortgeschrittenem oder metastasiertem nicht-kleinzelligen Lungenkrebs angezeigt, bei denen mindestens eine vorausgegangene Chemotherapie versagt hat.
1. What Tarceva is and what it is used for 2. What you need to know before you take Tarceva 3. How to take Tarceva 4. Possible side effects 5. How to store Tarceva 6. Contents of the pack and other information
This is based on cost considerations and a clinical discussion of the SATURN trial. What I am not sure about is whether Tarceva is recommended as a second-line treatment for metastatic lung cancer that has progressed through first-line chemotherapy. As far as I can tell, NICE have just started looking at that, with a prospective guidance issue date of June 2014:
“We believe our Tarceva promotional communications and practices were and are entirely proper and in compliance with the law,” said Andrew Villani, a Genentech spokesman.
I have almost never seen a patient go from tarceva to iressa. I really think of tarceva as the more powerful and effective of those two agents. I’ve written a post about a very limited number of cases of people who have done well on tarceva after progressing on iressa (cancergrace.org/lung/2008/09/28/tarceva-after-iressa/ ), but to me that is more anticipated than progressing on tarceva and then responding to iressa. I’ve read of a single case, which is one more than I’d have expected. I doubt there are many more in the world and haven’t been tempted to recommend this over a different treatment option for my patients.
"Tarceva remains the only epidermal growth factor receptor inhibitor to have demonstrated a survival benefit in patients with non-small cell lung cancer," the brokerage said.