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RISS 인기검색어
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- 저자 : Srimuninnimit, V. (검색결과 3 건)
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이대호,Vichien Srimuninnimit,Rebecca Cheng,Xin Wang,Mauro Orlando 대한암학회 2015 Cancer Research and Treatment Vol.47 No.4
Advances in oncology research have led to identification of tumor-specific biomarkers, someof which are important predictive indicators and ideal targets for novel therapeutics. Onesuch biomarker in non-small cell lung cancer (NSCLC) is the epidermal growth factor receptor(EGFR). Patients with NSCLC who harbor an activating EGFR mutation show a morefavorable response to treatment with an EGFR inhibitor, such as gefitinib, erlotinib, or afatinib,than to chemotherapy. The prevalence of EGFR mutations in East Asian patients ishigher than that in other populations, and in some clinical settings, patients have beentreated with EGFR inhibitors based on clinicopathologic characteristics with no informationon EGFR status. However, based on results from a series of studies in which East Asianpatients with advanced non-squamous NSCLC were treated with EGFR inhibitors alone orin combination with standard chemotherapy, this may not be the best practice becauseEGFRmutation status was found to be a key predictor of outcome. Data from these studieshighlight the necessity of EGFR testing in determining the most suitable treatment forpatients with advanced or metastatic NSCLC.
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Knox, J. J.,Barrios, C. H.,Kim, T. M.,Cosgriff, T.,Srimuninnimit, V.,Pittman, K.,Sabbatini, R.,Rha, S. Y.,Flaig, T. W.,Page, R. D.,Beck, J. T.,Cheung, F.,Yadav, S.,Patel, P.,Geoffrois, L.,Niolat, J.,B Oxford University Press 2017 ANNALS OF ONCOLOGY Vol.28 No.6
<P><B>Background</B></P><P>RECORD-3 compared everolimus and sunitinib as first-line therapy, and the sequence of everolimus followed by sunitinib at progression compared with the opposite (standard) sequence in patients with metastatic renal cell carcinoma (mRCC). This final overall survival (OS) analysis evaluated mature data for secondary end points.</P><P><B>Patients and methods</B></P><P>Patients received either first-line everolimus followed by second-line sunitinib at progression (<I>n = </I>238) or first-line sunitinib followed by second-line everolimus (<I>n = </I>233). Secondary end points were combined first- and second-line progression-free survival (PFS), OS, and safety. The impacts of neutrophil lymphocyte ratio (NLR) and baseline levels of soluble biomarkers on OS were explored.</P><P><B>Results</B></P><P>At final analysis, median duration of exposure was 5.6 months for everolimus and 8.3 months for sunitinib. Median combined PFS was 21.7 months [95% confidence interval (CI) 15.1–26.7] with everolimus-sunitinib and 22.2 months (95% CI 16.0–29.8) with sunitinib-everolimus [hazard ratio (HR)<SUB>EVE-SUN/SUN-EVE</SUB>, 1.2; 95% CI 0.9–1.6]. Median OS was 22.4 months (95% CI 18.6–33.3) for everolimus-sunitinib and 29.5 months (95% CI 22.8–33.1) for sunitinib-everolimus (HR<SUB>EVE-SUN/SUN-EVE</SUB>, 1.1; 95% CI 0.9–1.4). The rates of grade 3 and 4 adverse events suspected to be related to second-line therapy were 47% with everolimus and 57% with sunitinib. Higher NLR and 12 soluble biomarker levels were identified as prognostic markers for poor OS with the association being largely independent of treatment sequences.</P><P><B>Conclusions</B></P><P>Results of this final OS analysis support the sequence of sunitinib followed by everolimus at progression in patients with mRCC. The safety profiles of everolimus and sunitinib were consistent with those previously reported, and there were no unexpected safety signals.</P><P><B>Clinical Trials number</B></P><P>ClinicalTrials.gov identifier, NCT00903175</P>
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Mok, Tony S.K.,Wu, Yi-Long,Yu, Chong-Jen,Zhou, Caicun,Chen, Yuh-Min,Zhang, Li,Ignacio, Jorge,Liao, Meilin,Srimuninnimit, Vichien,Boyer, Michael J.,Chua-Tan, Marina,Sriuranpong, Virote,Sudoyo, Aru W.,J American Society of Clinical Oncology 2009 Journal of clinical oncology Vol.27 No.30
<B>Purpose</B><P>This study investigated whether sequential administration of erlotinib and chemotherapy improves clinical outcomes versus chemotherapy alone in unselected, chemotherapy-naïve patients with advanced non-small-cell lung cancer (NSCLC).</P><B>Patients and Methods</B><P>Previously untreated patients (n = 154) with stage IIIB or IV NSCLC and Eastern Cooperative Oncology Group performance status of 0 or 1 were randomly assigned to receive erlotinib (150 mg/d) or placebo on days 15 to 28 of a 4-week cycle that included gemcitabine (1,250 mg/m<SUP>2</SUP>days 1 and 8) and either cisplatin (75 mg/m<SUP>2</SUP>day 1) or carboplatin (5 × area under the serum concentration-time curve, day 1). The primary end point was nonprogression rate (NPR) at 8 weeks. Secondary end points included tumor response rate, NPR at 16 weeks, duration of response, progression-free survival (PFS), overall survival (OS), and safety.</P><B>Results</B><P>The NPR at 8 weeks was 80.3% in the gemcitabine plus cisplatin or carboplatin (GC) -erlotinib arm (n = 76) and 76.9% in the GC-placebo arm (n = 78). At 16 weeks, the NPR was 64.5% for GC-erlotinib versus 53.8% for GC-placebo. The response rate was 35.5% for GC-erlotinib versus 24.4% for GC-placebo. PFS was significantly longer with GC-erlotinib than with GC-placebo (adjusted hazard ratio, 0.47; log-rank P = .0002; median, 29.4 v 23.4 weeks); this benefit was consistent across all clinical subgroups. There was no significant difference in OS. The addition of erlotinib to chemotherapy was well tolerated, with no increase in hematologic toxicity, and no treatment-related interstitial lung disease.</P><B>Conclusion</B><P>Sequential administration of erlotinib following gemcitabine/platinum chemotherapy led to a significant improvement in PFS. This treatment approach warrants further investigation in a phase III study.</P>
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