[用药讨论]BIBW2992

土豆真是好东西 · 发表于 2011-5-12 22:29:51

BIBW2992究竟是不是阿法替尼？？？
据说这个组全国人招满了不招了
我妈妈现在是易瑞沙有效期，我心情很复杂，想多了解下要是耐药该用哪种方案。

瓶子 · 发表于 2011-5-17 18:02:13

bibw2992=阿法替尼

憨豆精神 · 发表于 2011-5-17 20:13:27

现在的药名很容易弄混：阿法替尼、阿帕替尼、法米替尼……起名用字真贫乏。

平安！ · 发表于 2011-5-21 12:01:56

美国2011年ASCO将于6月3-7日在芝加哥召开，论文的摘要都上网了。这一篇很好的advanced non-small cell lung cancer 用过特罗凯、多吉美耐药然后用BIBW2992的二期临床报告。
最近非常忙，有懂英文的病友给翻译一下。
A phase II trial of afatinib (BIBW 2992) in patients (pts) with advanced non-small cell lung cancer previously treated with erlotinib (E) or gefitinib (G).

Abstract:

Background: An unmet medical need exists in NSCLC pts after failure of E or G [reversible EGFR tyrosine kinase inhibitors (TKIs)], particularly in pts with T790M EGFR mutations, the most common mechanism of acquired resistance. Afatinib (A), an irreversible erbB family blocker, has preclinical activity against T790M. A was tested in this phase II study in pts enriched for acquired resistance to E or G. Methods: Pts in Japan with Stage IIIB/IV NSCLC (ECOG PS 0–1) who had progressed according to RECIST after 1–2 lines of chemotherapy and ≥12 wks of E or G received 50 mg A orally qd. The primary endpoint was objective tumor response. Results: Of 62 pts (F:48; M:14), 11.3%, 79% and 9.7% had received prior erlotinib, gefitinib or both, respectively. 65% of pts had achieved a prior response with E/G. Median duration between end of prior treatment with E/G and the start of A was 3 wks. 73% of pts were EGFR mutation-positive in their primary tumors. 82% of pts met the definition of acquired resistance to E/G by (1) EGFR mutation positive or (2) CR/PR to E/G or (3) SD for at least 6 months to E/G and (4) less than 4 wks off E/G. By investigator assessment, 13% of pts treated with A had a PR and the disease control rate (DCR >8 wks) was 72%; these values were 8.2% and 67%, respectively, by independent review. Median PFS was 4.6 months. Similar efficacy was seen in those pts meeting acquired resistance criteria (5.9% PR; 69% DCR; median PFS of 4.4 months, by independent review). Two pts had T790M mutations in their primary tumors; one, harbouring L858R+T790M, had a long SD (308 days). At data cut-off, the 25th percentile of OS was 10.6 months. Common adverse events included diarrhea, rash/acne, stomatitis, nail effects and decreased appetite. Conclusions: Pts in this study largely meet criteria for acquired resistance to first generation EGFR TKIs in NSCLC. Afatinib has demonstrated clinically meaningful efficacy (including 69% DCR >8 wks and 4.4 month median PFS) in these pts.

bbwy · 发表于 2011-5-24 20:19:10

之所以靶向药的名字都大同小异可能是因为它们的分子式都相近吧！

玛雅 · 发表于 2011-5-30 00:01:09

我来汇报一下老爸吃2992的情况，上个月吃了一个月法米替尼，吃到20多天的时候，手上长了10几个水泡泡，正作用是咳嗽减少，CEA降了30%。一个月停了法米替尼换了2992，今天第12天，副作用表现不明显，就是眼睛以下像太阳晒了一样黑黑的，有点打隔，好像消化不是太好，不过饭量并没有减少。还没有检查指标，再过3天去查CEA和肝功能。