非小细胞肺癌精准治疗新进展-关注脑转移.ppt

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1、非小细胞肺癌个体化治疗新进展----关注脑转移内容ALK+NSCLC脑转移的治疗EGFR+NSCLC脑转移的治疗PROFILE1014脑转移亚组分析：克唑替尼一线治疗与化疗比较的颅内疗效分析KeyentrycriteriaALK-positivebycentralFISHtestingaLocallyadvanced,recurrent,ormetastaticnon-squamousNSCLCNopriorsystemictreatmentforadvanceddiseaseECOGPS0−2Measurable

2、diseaseStablebtreatedbrainmetastasesallowedEndpointsPrimaryPFS(RECIST1.1,independentradiologicreview[IRR])SecondaryORROSIntracranialTTPeSafetyPatient-reportedoutcomesCrossovertocrizotinibpermittedafterprogressiondN=343RANDOMIZEcCrizotinib250mgBIDPO,co

3、ntinuousdosing(n=172)Pemetrexed500mg/m2+cisplatin75mg/m2orcarboplatinAUC5–6q3wfor≤6cycles(n=171)IntracranialefficacywasprospectivelyevaluatedintheITTpopulationandpatientswithandwithoutbrainmetastasesatbaselineeAbstract1238BaselineCharacteristicsofPatientsWith/

4、withoutBrainMetastasesatBaselineaBrainmetastasesbpresentBrainmetastasesabsentCharacteristicCrizotinib(n=39)Chemo(n=40)Crizotinib(n=132)Chemo(n=131)Age,yearsMedian(range)48(29−70)51(25−76)53(22−76)56(19−78)Sex,n(%)Male20(51)9(23)47(36)54(41)Race,n(%)CaucasianA

5、sianOther20(51)17(44)2(5)19(48)18(45)3(8)70(53)60(45)2(2)66(50)62(47)3(2)Smoking,n(%)NeversmokedEx-smokerCurrentsmoker23(59)13(33)3(8)28(70)12(30)083(63)43(33)6(5)84(64)42(32)5(4)Histology,n(%)Adenocarc.Largecellcarc.Adenosquamouscarc.Other35(90)1(3)2(5)1(3)38

6、(95)01(3)1(3)123(93)2(2)3(2)4(3)121(92)8(6)02(2)ECOGPS,cn(%)0/1235(90)4(10)34(85)6(15)125(95)6(5)129(98)2(2)Timesincefirstdiagnosis,moMedian(range)2.4(0−36.0)2.4(1.2−74.4)1.2(0−114.0)1.2(0−93.6)Carc.,carcinoma;abyIRR;bpreviouslytreatedperprotocol,althoughth

7、iscriterionwasnotfulfilledinallcasescAtscreening;datafor1patientmissingforcrizotinibAntitumorActivity−PFSandORRaITTpopulationBrainmetastasespresentbBrainmetastasesabsentbCrizotinib(N=172)Chemo(N=171)Crizotinib(n=39)Chemo(n=40)Crizotinib(n=132)Chemo(n=131)Me

8、dianPFS,mo(95%CI)10.9(8.3–13.9)7.0(6.8–8.2)9.0(6.8–15.0)4.0(1.5–6.8)11.1(8.3–14.0)7.2(6.9–8.3)HR(95%CI)0.45(0.35–0.60)0.40(0.23–0.69)0.51(0.38–0.69)Pc<0.001<0.001<0.001O